Courting Justice: What Every Woman Must Know about Mammography

April 3, 2013

By Robert N. Hunn

You’ve just had a mammogram. Now you’re waiting for the phone call informing you of the results. Back at the office, the doctor receives faxes from the various imaging centers that have performed mammography on his patients. A nurse or office worker collects the faxes and typically makes two piles. In one pile, she places all the faxed results that have come back normal. In the other pile, she places the results that show an abnormality.

The abnormal reports are placed on the doctor’s desk. The nurse begins the process of calling all of the other patients and telling them their mammogram was clean. You’re told your mammogram was normal and you are relieved.

But, there’s a problem. And one that not all doctors are telling their patients.

If a woman has what is referred to as dense breast tissue, regular mammography may not detect or identify a cancerous mass. There is a risk that mammograms of a women with dense breasts can be read as normal when they are not.

Unfortunately, too many physician offices are not telling their patients that they have dense breast tissue. They do not tell patients there are further tests that can more adequately identify a cancerous mass. Instead, they simply report back to the patient that their mammogram was normal, without the patient knowing of the possibility that the mammogram was non-diagnostic for cancer.

But you have options. Here’s what you can do:

Find out for yourself whether the mammogram is reporting that you have dense breast tissue. Susan G. Komen for the Cure has made a handy checklist of questions to ask your doctor. Ask whether film mammography or digital mammography was performed. Digital mammography is more accurate and provides a better chance of identifying a tumor in dense breasts. If you have dense tissue and the mammogram was read as normal, you can arrange to have either an ultrasound or MRI, which will give you the best chance of identifying an early cancerous mass.

Now, here is some bad news. The insurance industry is not paying for post-mammogram ultrasounds and MRIs. But here is some good news—an ultrasound should cost around $50 and can easily be arranged at the radiology department of your local hospital.

As a trial lawyer, one type of case I should never see is the young woman whose breasts were dense and whose breast cancer should have been diagnosed three years earlier if only her physician had told her that she had dense breast tissue and she could have an ultrasound for fifty bucks.

Unfortunately, I see those cases. I pursue those cases. And I get angry when the defense hires an expert to testify that it is not the standard of care to tell a woman that her ultrasound showed dense breast tissue, and that it is not the standard of care to recommend an ultrasound.

That’s not the doctor’s responsibility? That is not part of his duty to his patient?

The standard of care for a doctor should always involve acting in the best interest of his or her patient. In what universe is it ok to allow a woman’s breast cancer to advance to the point where it’s not treatable and the woman is destined to die? Not in my universe.

Tort reformers would argue that we are increasing the cost of healthcare with additional defensive medicine. I would argue that we are potentially saving someone’s life. What do you think?