Case
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A 27 year old woman presented in Oct 1997 with complaints of alump at 6 o’clock in her right breast. The physician was able topalpate several small cysts and other signs of fibrocystic changes,but felt no dominant mass and told her to return in 6 weeks. Shereturned and the physician could palpate nothing at that time. Shereturned in 3 months and the test showed the same result.
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At her annual test in May, 1998, a mass was palpated at 9o’clock in the right breast. She had a negative mammogram, but theultrasound was positive for a solid mass. Excisional biopsy showedinfiltrating ductal carcinoma. She had no positive nodes, underwentmastectomy with reconstruction and is still cancer-free.
Allegation
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The patient alleges failure to diagnose breast cancer and thatmammography of biopsy should have been done in October 1997.
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What do you think?
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What comments can you make about what you would “expect” insomeone her age?
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Comment on the lump being first at 6 then at 9 o’clock.
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How do you think the doctor handled the case? Appropriately? Isthere anything that you think he/she should have done differently?Discuss the appropriateness of the diagnostic tools used and defendyour answer.
