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1.
Radiology ; 189(3): 673-6, 1993 Dec.
Article in English | MEDLINE | ID: mdl-8234689

ABSTRACT

PURPOSE: To identify causes of purported malpractice in diagnosis and treatment of breast cancer. MATERIALS AND METHODS: The authors reviewed cases from The New York Jury Verdict Reporter listed between 1985 and 1991 to look for those in which there was alleged delay in diagnosis or treatment of breast cancer. RESULTS: Of 34 cases identified, 32 (94%) were based on presumed delay in diagnosis and only two (6%) on claims of therapeutic malpractice. Delay in diagnosis was commonly claimed in patients younger than 50 years (76%). Palpable masses were present in 94% of these cases. Either mammograms were not obtained (16 cases, 50%) or findings were interpreted as normal or as fibrocystic disease (12 cases, 38%). Specialists most frequently cited were gynecologists (16 of 39,41%). Highest awards (> or = $1 million) were more commonly given to patients younger than 50 years with proved distant or nodal metastasis (six of 34, 18%). CONCLUSION: Emphasis on early diagnosis has led to the perception that purported delay in diagnosis, however short, even in the presence of a palpable mass, changes the chances for survival.


Subject(s)
Breast Neoplasms , Gynecology/legislation & jurisprudence , Internal Medicine/legislation & jurisprudence , Malpractice/legislation & jurisprudence , Obstetrics/legislation & jurisprudence , Adult , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Breast Neoplasms/therapy , Female , Humans , Malpractice/statistics & numerical data , Mammography , Middle Aged , New York/epidemiology , Time Factors
2.
Ann Plast Surg ; 31(3): 238-40, 1993 Sep.
Article in English | MEDLINE | ID: mdl-8239413

ABSTRACT

Nonpalpable nodules in patients with breast implants may represent silicone granulomas, fibrocystic mastopathy, or cancer. We describe a modified technique for needle localization which facilitates the surgical excision of these nodules while minimizing the possibility of rupture.


Subject(s)
Breast Diseases/surgery , Mammaplasty/adverse effects , Prostheses and Implants/adverse effects , Breast Diseases/etiology , Equipment Design , Female , Humans , Needles
3.
Ann Plast Surg ; 31(3): 241-4, 1993 Sep.
Article in English | MEDLINE | ID: mdl-8239414

ABSTRACT

Six patients with augmentation prostheses presented with a firm, painless, breast mass that could not be visualized by mammography. One lesion was demonstrated to be solid by ultrasound, and the remaining sonograms were nondiagnostic. The lesions were indistinguishable from carcinoma, by physical examination. All of the patients had fine needle aspiration biopsy despite close proximity to the implant. The patients all had silicone granulomas related to silicone leakage. Our experience suggests that fine needle aspiration biopsy is a useful technique to evaluate palpable breast masses that are not visualized by mammography in patients with augmentation prostheses.


Subject(s)
Biopsy, Needle/methods , Breast Diseases/diagnosis , Granuloma/diagnosis , Mammaplasty/adverse effects , Prostheses and Implants/adverse effects , Silicones/adverse effects , Breast Diseases/etiology , Female , Granuloma/etiology , Humans
4.
Radiology ; 188(2): 457-62, 1993 Aug.
Article in English | MEDLINE | ID: mdl-8327697

ABSTRACT

Stereotaxic fine-needle aspiration biopsy (SFNAB) was performed to evaluate suspicious mammographic findings (31 stellate lesions, 20 regions of grouped calcifications, two nodules, and one area of prominent trabecular markings) in 54 patients who had undergone reduction mammaplasty. SFNAB findings were correlated with findings in histologic specimens whenever possible; the cytologic samples were classified as malignant, atypical, or benign. In 22 lesions, the abnormalities on mammograms were considered highly suspicious for malignancy. In the 32 others, the degree of suspicion was lower, but these lesions had a change in appearance since acquisition of the first postoperative mammogram. SFNAB enabled diagnosis of adenocarcinoma in five women. Patients who have undergone mastectomy with reconstruction of one breast and mammaplasty in the other are at higher risk for development of contralateral breast cancer, as are all patients who have had such cancer. SFNAB is reliable for evaluation of suspicious mammographic abnormalities that develop after mammaplasty and findings that change after acquisition of the first postoperative mammogram.


Subject(s)
Biopsy, Needle , Breast Diseases/pathology , Breast Neoplasms/pathology , Carcinoma/pathology , Mammaplasty , Stereotaxic Techniques , Adult , Breast Diseases/diagnostic imaging , Breast Neoplasms/diagnostic imaging , Carcinoma/diagnostic imaging , Female , Humans , Mammography , Middle Aged , Postoperative Complications/pathology , Postoperative Period
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