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    Missing the Diagnosis

    When a mammogram fails, does a woman have the right to sue?

    WebMD Feature

    April 3, 2000 (Chantilly, Va.) -- Carol Fubini thought she was safe from breast cancer after her radiologist reported that her latest mammogram showed no evidence of the disease.

    Then 43, Fubini had received similar reports after three other mammograms over the previous five years. Her latest, she thought, was yet another clean bill of health.

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    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 history.

    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 and 1992.

    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.

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