$300,000 Settlement for Medical Malpractice - Failure to Diagnose Breast Cancer

The 39-year-old plaintiff was seen by defendant #1 from 1993 through 1995. At the first visit, in February 1993, the plaintiff complained of a possible lump in the upper outer quadrant of the left breast. Needle biopsy was performed and two specimens were obtained. At least one of the specimens was determined to have come from the area in question. Biopsy results were negative.

A follow-up mammogram was performed in July 1993, and no abnormal findings were noted. The mammogram did show a density, which was interpreted as post-surgical scarring from the previous biopsy procedure. Follow-up mammograms in 1994 and early 1995 were essentially unchanged. Some months after the biopsy in 1993 and 1994, the plaintiff reported some occasional discharge from the breast. The discharge resolved on its own.

In October 1995, the plaintiff was seen by defendant #2, a surgeon, with complaints of a lump in the left breast. Defendant #2 could feel an induration in the inner portion of her breast, but he could not find a lump. A mammogram was performed and the radiologist noted an area of density, which he reportedly thought was slightly increased from the previous study. Defendant #2 reviewed the films. He found no evidence of any change in the outer portion of the breast, but reportedly saw a density in what he thought was the area of the induration.

To further evaluate the area, defendant #2 ordered a follow-up study, which was to be performed with a skin marker placed on the inner portion of the breast where the defendant felt the induration. A lesion was not identified. He then ordered an ultrasound, which was performed in November 1995. No abnormality was identified. A follow-up mammogram was performed in March 1996 and no changes were reported.

In July 1996, the plaintiff saw defendant #2 again. The plaintiff was still complaining about a lump in the inner portion of the left breast. Again, defendant #2 reportedly could not find a lump, but because of the plaintiff's persistent complaints he ordered an aspiration biopsy to evaluate the area of question. Aspiration was reported as non-diagnostic, although a single cluster of slightly atypical cells was identified.

The plaintiff relocated in late 1996 and was seen by a physician for the first time in March 1997 with complaints of a breast lump. A mammogram and breast ultrasound were performed. The mammogram was still negative. The ultrasound, however, showed several smooth appearing solid nodules.

A biopsy was performed and revealed a nodular focus of poorly differentiated infiltrating lobular carcinoma. Mastectomy was performed, and the plaintiff was found to have metastatic cancer (also lobular) in nine to 12 lymph nodes. She was diagnosed as T2N1, clinical Stage II. She underwent chemotherapy and radiation.

According to the records, as of the time the plaintiff was diagnosed with cancer, she was at high risk for recurrent metastatic cancer. Despite her poor prognosis, when the case was resolved, which was more than five years after the diagnosis, the plaintiff was in good health and cancer free.

The plaintiffs alleged that defendant #1 should have repeated the biopsy and performed additional evaluation and testing during the period of time that the plaintiff was experiencing discharge from the breast. With regard to defendant #2, the plaintiffs alleged that he deviated from the standard of care in failing to perform an open biopsy.

The defendants and their experts were expected to testify at trial that each of the defendants performed multiple and appropriate diagnostic tests on the plaintiff, all of which were negative; the plaintiff was ultimately found to have lobular cancer, which is known to be difficult to diagnose; and that the plaintiff's diagnosis, treatment and prognosis would have been the same had she been diagnosed and treated earlier.

The case settled following discovery.