Breast cancer is diagnosed in approximately 180,000 women per year resulting in nearly 45,000 deaths in the United States each year. Breast cancer accounts for 1 of every 3 cancers diagnosed. Because 1 of every 7 to 8 women will be diagnosed with breast cancer during their lifetime, all women should be alert for signs of breast cancer. The risk of a woman developing breast cancer is significant. Risk factors associated with breast cancer include:
- Early age at the onset of menarche
- Late age at onset of menopause
- First full term pregnancy after age 30
- Personal history of breast cancer
- Family history of breast cancer
- Personal history of benign proliferative breast disease
- Obesity
-
Nulliparity
Breast Cancer Screening
The introduction of screening programs for breast cancer resulted in an increase number of breast cancers detected. This higher detection rate was accompanied by the detection of smaller lesions and an increase in the detection of ductal carcinoma in situ (DCIS). The diagnosis of smaller and more localized in situ cancers has translated in a decrease in the mortality rate from breast cancer. Signs possibly associated with breast cancer include:
- lump or lumps in breast tissue
- lump or mass in the armpit
- thickening of breast tissue
- change in size or shape of the breast
- pain in one breast
- nipple pain in one breast
- abnormal nipple discharge
- nipple retraction
- dimpling or swelling of one breast
The evaluation of a breast complaint requires a diagnostic work-up. A diagnostic work-up is more intensive than a screening evaluation based on risk factors for breast cancer. Screening for breast cancer includes:
- Breast self-examination
- Breast examination by medical provider
- Mammography
- Magnetic resonance imaging (MRI)
Screening mammography is the preferred examination for asymptomatic woman at risk for breast cancer. Current recommendations for screening mammography in women without a family history of breast cancer include a baseline mammogram between ages 35 and 40 followed by a biennial mammogram between ages 40 and 49 and annual mammograms after age 50.
Most breast cancers are adenocarcinomas located in the ducts or lobules of the breast thus called ductal or lobular in origin. Cancer of the breast can also be classified as in-situ or invasive (infiltrating). Depending on the amounts of ducts involved in a ductal carcinoma in situ (DCIS), it is further classified as localized or diffuse. Ductal carcinoma is believed to progress from intraductal hyperplasia → atypical ductal hyperplasia → ductal carcinoma in situ (DCIS) → invasive ductal carcinoma. Ductal carcinoma accounts for 75% of breast cancers.Invasive breast cancer can be localized, regional or metastatic. Breast cancer can become invasive by disseminating to the lymphatics and the bloodstream. The most common classifications for staging of breast cancer are Stage 0 to IV and TNM (Tumor, Nodes, Metastasis). These classifications take into account the size of the tumor, the number of nodes that may be involved and its spread.
In addition, a woman with a positive family history of breast cancer has an increased risk of developing breast cancer during her lifetime. Familial breast cancers constitute 15% to 20% of all breast cancers. One half of women with familial breast cancer history have a mutation in a heritable gene called BRCA1 and BRCA2. Women who carry a BRCA1 or BRCA2 gene mutation are considered to be at a higher risk of developing breast and ovarian cancer. The BRCA1 and BRCA2 serve as susceptibility genes to promote tumorigenesis. Patients with BRCA1 or BRCA2 gene mutations should undergo genetic counseling and be screened with breast MRI scans which have shown to be superior over other screening modalities.
Effective treatment is directly related to the earliest stage a breast cancer is diagnosed. If your doctor (nurse) fails to diagnose your breast cancer in a timely fashion, it often results in delayed treatment with severe, debilitating injuries and sometimes death. If you feel that your health care provider (doctor, nurse) delayed in any way your diagnosis of breast cancer, contact us to discuss your particular situation. Protecting your legal rights will benefit you and your family.
If you (or a loved one) are suffering from complications due to a failure to timely diagnose, delayed diagnosis or misdiagnosis of breast cancer, or the recommended screening guidelines were not followed, let our Boston area medical malpractice attorneys at Barry D. Lang, M.D. & Associates evaluate your case. We can help you assert your rights and get the compensation you deserve.
