Could My Wife’s Breast Cancer Have Been Detected Earlier?

By Dr. Gerald B. Parker, III, M.D., J.D.

Breast cancer is the most commonly diagnosed cancer in women. It is estimated that 1 in every 8 women will be diagnosed with breast cancer in her lifetime. With statistics like that, it's not surprising that delayed diagnosis of breast cancer is one of the most common reasons for medical malpractice suits in the country. Studies published in the Archives of Internal Medicine showed that between 6 and 16 percent of women with breast cancer experienced physician-caused delay in their diagnosis, suggesting that treatment was delayed for at least 10,000 of the roughly 180,000 women diagnosed with breast cancer each year.

How Do Doctors Diagnose Breast Cancer?

Many women's breast cancer journeys begin when they find a lump in their breast during a self-exam. However, breast cancer can be present even in the absence of any physical symptoms, which is why doctors encourage women to get annual mammograms. Doctors will begin by taking a comprehensive medical history, asking if there is a history of breast cancer in the woman's family and going over any symptoms she may be experiencing. The doctor would then examine the breast, looking for any suspicious areas and checking the texture/size of any lumps.

If the doctor thinks cancer may be a possibility, he will order additional testing, including a mammogram. Mammograms take X-ray images of a woman's breast, making it possible to detect tumors that cannot be felt. This imaging test can also reveal microcalcifications that can indicate the presence of breast cancer. From there, a biopsy may be ordered if the mammogram shows the abnormal area of a woman's breast is suspicious for cancer. Biopsying the breast and any lumps present is the only sure way to determine if a woman has breast cancer.

Why Are Breast Cancer Diagnoses Delayed?

Despite the advances in testing for breast cancer, doctors sometimes fail to diagnose breast cancer. Reasons for misdiagnosis can include:

• Misinterpreting the results of a mammogram. Although mammograms are extremely helpful in diagnosing breast cancer, they are not always accurate. The American Cancer Society estimates that screening mammograms miss 1 in every 5 breast cancers.
• Disregarding the presence of persistent breast lumps. When a woman has a palpable lump in her breast, it should be taken seriously. But some doctors quickly write off these lumps as being benign or nothing to worry about without ordering any tests. Other symptoms that should not be ignored include changes in the size of a woman's breast, discoloration of the skin on the breast, and dimpling of the skin.
• Failing to order additional testing. If a mammogram is abnormal or if the results are inconclusive, additional testing should be ordered to determine if a woman has cancer. Unfortunately, some doctors simply assume this means lumps are benign and never order these tests.
• Failing to refer a patient to a specialist. General Practitioners and OB/GYNs have the knowledge and training to get the process started, performing physical exams and ordering and interpreting mammograms. But when those tests are inconclusive, they likely don't have the skills necessary to move forward, which is why a specialist should be referred.

When a diagnosis and treatment is delayed, a woman's chances of surviving breast cancer decrease. According to the National Cancer Institute’s SEER database, women who are diagnosed with stage 0 or stage 1 breast cancer have a 100 percent survival rate after five years. When diagnosed in stage 2, that drops to 93 percent, and then to 72 percent when diagnosed in stage 3. Women diagnosed with stage 4 breast cancer only have a 22 percent five-year survival rate.

What Can You Do?

As breast cancer progresses, it can cause women to feel discomfort or pain in their breasts, fatigue, insomnia, as well as loss of appetite and weight loss. The longer a woman goes undiagnosed, the longer she could be with these life-disrupting symptoms. Delayed diagnoses can also significantly decrease a woman's chances of surviving breast cancer. If you believe your wife's breast cancer could have been detected earlier but was delayed due to your physician's actions, contact us to explore your options.