Minimizing the Risk of Delayed Diagnosis of Breast Cancer.
According to the Physician Insurers Association of America (PIAA), the most expensive and common medicolegal claim against physicians related to errors of diagnosis in malignant diseases is delay in the diagnosis of breast cancer. Although just 40% of all breast cancers occur in women younger than 50 years old, 60% of the claims of a delayed diagnosis of breast cancer arise in this group. Unimpressive findings on a physical exam (54.7%) topped the list of reasons for physician-related causes of delay in diagnosing breast cancer. Other factors in the PIAA survey included negative mammogram report (35.7%), failure to do an appropriate biopsy to evaluate a suspicious mass (26.8%), no suspicious findings discovered on repeat exam (24.5%), delay in requesting a consult or in referring a patient for further evaluation (18.2%), record-keeping errors (16.0%), inadequate physician-to-physician communication (13.8%), physician distraction by patient's other health problems (12.3%), mammogram misread (8.8%), and poor physical examination done by physician (5.9%). Three elements are vital to an effective breast-screening program: a comprehensive breast history, a thorough breast examination, and a clear record of findings and follow-up.
Steyskal
R
Breast Care Medical Group in Redding, Calif.