Triple-negative breast cancer (TNBC) is defined as the absence of staining for estrogen receptor, progesterone receptor, and HER2/neu. TNBC is insensitive to some of the most effective therapies available for breast cancer treatment including HER2-directed therapy such as trastuzumab and endocrine therapies such as tamoxifen or the aromatase inhibitors. Combination cytotoxic chemotherapy administered in a dose-dense or metronomic schedule remains the standard therapy for early-stage TNBC. A prospective...
Several months later, however, her confidence was shattered: while doing a
routine exam of her left breast, Fubini found a lump. A biopsy was performed.
It showed that Fubini had cancer -- specifically, a ductal adenocarcinoma that
eventually was determined to have spread to her lymph nodes.
Fubini had a mastectomy, chemotherapy, and radiation. She also fought back
in another way: filing a lawsuit against the radiologist she believes should
have detected her cancer before she did.
"I had started wondering afterward how I could have fairly advanced
cancer -- they said I was stage three -- when I had had a mammogram six months
before I felt this lump," she said. "I really started to think about
whether something had been overlooked."
A Major Case That Sent Shock Waves
Last May, after just three hours of deliberation, a Massachusetts jury
awarded Fubini $5.5 million, one of the largest malpractice awards in state
The jury agreed with the testimony of expert witnesses who claimed that her
radiologist should have discovered Fubini's cancer on mammograms done in 1989
Fubini, whose cancer recurred and has now spread to her ribs, said she was
"relieved" by the jury's decision.
"If I could have advanced breast cancer -- just six months after my
clean mammogram --then everything they tell women about mammograms, and
self-examination, and testing is all a sham," she says.
The Truth About Mammograms: They're Not Perfect
Fubini's case illustrates a growing awareness that mammograms aren't
perfect. Indeed, according to the Food and Drug administration, studies show
they reveal about 80 of every 100 cancers. At the same time, more and more
patients are filing lawsuits when lesions are found after earlier mammograms
failed to detect them.
Last year alone:
A Florida jury awarded a 56-year-old woman $3.35 million after she claimed
her breast cancer diagnosis was delayed six months because her cancer was
missed on a mammogram.
A Hawaii jury awarded a 57-year-old woman $1.32 million after she said her
breast cancer diagnosis was delayed 17 months because her radiologist erred in
reading her mammogram.
And in Houston, the estate of a 60-year-old woman was awarded $3.9 million
because she was not diagnosed with breast cancer until 1996, despite mammograms
in 1994 and 1995 that indicated that she had the disease.
Radiologists are well aware of such cases. "The number of medical
malpractice lawsuits alleging injury due to missing or delayed diagnoses of
breast cancer has increased so rapidly that such lawsuits have now reached
epidemic proportions," wrote Leonard Berlin, MD, chairman of radiology at
Rush-Presbyterian-St. Luke's Medical Center in Chicago, in the November 1999
issue of the American Journal of Roentgenology.