June 30, 2011

Our last blog discussed screening mammograms for breast cancer, which use x-rays to visualize inside the breasts. If the screening mammogram indicates an abnormality that needs further investigation, a more detailed x-ray known as a diagnostic mammogram may be ordered to further examine the suspicious area. Your doctor may also order a breast ultrasound (also known as a sonogram) that uses soundwaves to visualize the breast tissues in more detail. Another option for more detailed diagnosis is magnetic resonance imaging (referred to as an “MRI”) that uses a large and powerful magnet housed in a tube-like structure (some MRIs are not fully enclosed in tubes and are often referred to as “open MRIs”) to scan the breasts or other areas of the body during which a computer will be used to form detailed images of the soft tissues of the body. If necessary or otherwise appropriate, a biopsy may be done that sometimes uses a fine needle to extract a small amount of tissue or fluid from the breast that will be examined under a microscope to determine if there are suspicious cells or other structural abnormalities that may indicate cancer or some other disease process affecting the breast.

If breast cancer is detected,  further testing or procedures are done to determine the type of the cancer as well as whether the cancer has spread within the breast or to other parts of the body. Additional testing such as chest x-rays (to determine if the cancer has spread to the lungs), a bone scan (to determine if the cancer has spread to the bones), computed tomography (CT) scans, and/or a positron emission tomography (PET) scan may be useful in determining if the cancer has spread and to what parts of the body.

The cancer may be found only in the breast or may spread to the lymph nodes under the arm or to other areas in the body. The extent and spread of the cancer is usually referred to as “staging.” It is important to determine the stage of the cancer because treatment and outcomes often vary according to the stage of the cancer. Staging determines if the cancer is only in the breast, is found in lymph nodes under the arm, or has spread outside the breast. The type and stage of breast cancer determine what kind of treatment will be needed.

The most commonly used staging system is the American Joint Committee on Cancer (AJCC) TNM system. The staging is usually described either as clinical staging based on physical examination, biopsy, and imaging tests or pathologic staging based on the additional benefit of  the result of surgery during or after which a pathologist examines tissues and lymph nodes under a microscope. Because of the added benefit of the pathologist’s report, pathologic staging is considered more accurate than clinical staging.

The TNM staging system classifies cancers based on their T (primary tumor categories), N (nearby lymph nodes), and M (metastasis – the spread of the cancer to other parts of the body) stages in which the letter T followed by a number from 0 to 4 describes the tumor’s size and spread to the skin or to the chest wall under the breast (the higher T numbers mean a larger tumor and/or wider spread to tissues near the breast); the letter N followed by a number from 0 to 3 indicates whether the cancer has spread to lymph nodes near the breast and, if so, how many lymph nodes are affected; and, the letter M followed by 0 or 1 indicates whether the cancer has spread to distant organs — for example, the lungs or bones.

Sources: CDCACS

If you or a loved one suffered from breast cancer that was not caught in time, you may have a medical malpractice claim. To help determine if the late or misdiagnosis of the cancer was due to medical negligence, you should contact a medical malpractice lawyer to investigate your potential medical malpractice claim. Visit our website to be connected with medical malpractice lawyers in your local area who may be able to help you with your medical malpractice questions. You may also reach us toll free at 800-295-3959.