There are various steps involved in making a correct diagnosis of if a woman has breast cancer. First, whether through routine screening or through a physical examination, a suspicious change in the breast is detected. Next an aspiration or biopsy of the area is likely performed. Once the results are known if the patient has cancer appropriate treatment can be recommended. A diagnosis that there is no cancer in someone who fact does have cancer can allow the disease to spread and become fatal. A diagnosis of cancer in someone who is in fact cancer free can lead to unnecessary treatment including the partial or full loss of breast, and possible complications from treatment. For example, consider the allegations from the following documented case.
Following detection of an area of thickening in a woman’s breast her physician did in aspiration in order to determine whether the changes in her breast were benign or were the result of cancer. The specimen from the aspiration was forwarded to a hospital’s pathology department. A clerk in the pathology department received the specimen and placed the wrong identification number on it. The clerk mixed up the number assigned to the woman’s specimen with that which was assigned to a different specimen. When the specimen from the other person was examined by a pathologist cancer was detected. Given the mix up in the labeling the cancer was reported as belonging to the woman.
As a result it was recommended by her doctors that the woman undergo a partial mastectomy in order to remove the area thought to be cancerous. Generally when such a procedure is done only the sentinel node associated with the breast is removed and analyzed during the procedure. The analysis of the node is completed during the procedure. If the results of the analysis indicate that there is no cancer present in the sentinel node, then no other nodes are removed, sparing the woman the need to undergo the more invasive procedure and the possibility of complications which can arise from the removal of multiple lymph nodes in that area. Additional lymph nodes are thus only generally removed if the sentinel node is found to have cancer. The surgical oncologist who performed the surgery had explained this process to the woman prior to surgery and had documented it in writing. Yet, the doctor took out seven of her lymph nodes.
The standard protocol following this type of surgery is to analyze the tissue and lymph nodes removed. The analysis in this case revealed that there was no cancer present. Her surgical oncologist however did not inform her of this development. The woman learned about this independently when she checked her own records. Due to her inquiries over the situation the hospital re-examined the original specimen. Once again cancer was found in the still mislabeled specimen. The hospital told her that no mistake had been made and that she did in fact have cancer. Not satisfied with that explanation given the lack of any cancer in the tissue and lymph nodes removed during the surgery the woman pressed her surgical oncologist for an explanation. When a full review was done it became clear that there had been mix up leading to the mislabeling of the original specimen with that of another patient. Her original specimen did not contain any cancer.
Instead of revealing the mistake the hospital allegedly initially gave the woman different accounts of what had happened – everything from telling her that her specimen could not be found to telling her that not all of the area involved had been removed through the surgery and that she might still have cancer in her breast. As she continued to press she ultimately met with the head pathologist and learned of the mistake.
As a result of the surgery she not only lost a significant portion from her breast and in the area of the lymph nodes, she also developed lymphedema. Lymphedema can be a very painful condition for which there is no cure. She was unable to continue with her job which required the use of her arm.
The woman and her husband pursued a lawsuit against the lab clerk and the hospital. The hospital allegedly admitted the mistake but maintained the position that the damages were not significant and did not merit a substantial recovery. The law firm that handled the case reported that at the end of the trial the jury awarded the woman and her husband $3 million.