Legal: Failure to biopsy a breast

March 1, 2009

Surgeon fails to biopsy a breast with positive mammogram.

A 31-YEAR-OLD NEW YORK WOMAN HAD A routine mammography in 2002, which the radiologist interpreted as negative for cancer. Three months later, the patient visited her long-time obstetrician and was referred to a breast surgeon for evaluation of a lump in her left breast. She had a family history of breast cancer and had episodes of breast cysts herself. The surgeon documented a palpable 1-cm lesion in the left breast and after reviewing the mammogram with a radiologist, she concluded it was normal fibronodular glandular tissue. The patient was instructed to follow-up in 5 months. When she returned, she was 10 weeks pregnant. The breast surgeon could not palpate the lesion and recommended a return visit in 5 months. No lump was found at the following exam, but the surgeon noted her breasts were congested due to pregnancy. A month later, the woman went to her obstetrician with complaints that her breasts were very sore and of a large lump on the left side. She was sent that day for a mammogram, which revealed a 3-cm lesion. The biopsy revealed a malignant breast tumor that had spread to her lymph nodes. She immediately began chemotherapy, with one treatment given prior to delivery. Subsequently, she underwent a radical mastectomy with 14 of 15 lymph nodes being positive for cancer. Six months later, no further cancer was found, but a few months later she complained to her family physician of a loss of visual acuity. Orbital metastasis was diagnosed and a few days later, pulmonary metastasis was also found. She died 2 days later.

The lawsuit filed on her behalf against the breast surgeon and the radiologist claimed that a timely biopsy would have detected the cancer at an earlier stage and prevented her death.

The surgeon claimed the lump had been movable and soft during the first exam, that the negative mammogram made a biopsy unnecessary, and that the patient's pregnancy made examination during the second visit difficult. The jury returned a verdict for the patient and awarded $9,057,960.