Medical Misdiagnoses Are Common - Always Push For Answers
- Elena Ivanova, 61, was recently awarded $400,000 by a jury for a negligent misdiagnosis, however, her pathologist has appealed the verdict. Now, as she’s awaits the court’s final decision following her incorrect diagnosis of metaplastic carcinoma and the mastectomy that followed, she is insisting that “people have to be protected.”
- Metaplastic carcinoma is a rare and aggressive form of breast cancer that’s often found as fast-growing lump in the breast. According to the National Library of Medicine, Metaplastic breast cancer (MBC) “is a rare neoplasm accounting for less than 1% of all breast cancer. “
- Leading experts tell SurvivorNet why getting multiple opinions is always best to avoid a misdiagnosis or provider bias.
- The story comes as a recent study estimated that 800,000 Americans suffer “serious harm” due to misdiagnosis every year. That includes an estimated 371,00 people who die every year and around 424,000 who are permanently disabled.
Now, as the 61-year-old dog groomer is awaiting the court’s final decision following her incorrect breast cancer diagnosis and the mastectomy that followed, she is insisting that “people have to be protected.”
Read MoreSpeaking to CBC News in a recent interview, Ivanova recounted how a B.C. Cancer oncologist informed her she was misdiagnosed at an appointment which was intended to go over her treatment plan.
“The doctor said, ‘I have good news. You don’t have cancer,'” she told the news outlet. “It’s hard to describe what I felt. For what I had this surgery? …
“I know it’s good news, but it was very, very, very hard, because it’s a human body. If you damage it, you can’t restore it.”
A B.C. Supreme Court civil jury awarded Elena Ivanova $400,000 in damages from the pathologist who wrongly diagnosed her with breast cancer. But the verdict has been held back and it will be months before Ivanova has a resolution. https://t.co/i7xgPIsAyE
— CBC News (@CBCNews) July 25, 2023
It wasn’t until May 2023, Ivanova was awarded $400,000 by a B.C. Supreme Court civil jury from pathologist Dr. Robert Wolber, who wrongly diagnosed her. But since the doctor has appealed the verdict, Ivanova may be waiting months for the “truth.”
“I really wanted to find the truth. People have to be protected. Mistakes like this shouldn’t be done, and if they are done, it needs to be fixed,” Ivanova said.
As Ivanova awaits what comes next, she has complained of how the misdiagnosis has damaged both her physical and mental health.
“I was always in good physical condition, but after the surgery I started to have nightmares. I couldn’t sleep properly,” she explained. “I don’t feel like I’m an attractive woman anymore. I have to hide my damage. I threw away all my beautiful dresses.”
When Should You Consider a Mastectomy?
Ivanova also said she suffers from weakness and back pain which she claims she had never experienced prior to her misdiagnosis.
Meanwhile, her pathologist Wolber has since denied any negligence and maintained that “all medical procedures and investigations carried out by him with respect to the plaintiff were appropriate to the circumstances and in accord with standard medical practice,” according to CBC News.
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However, Johns Hopkins University pathologist Dr. Ashley Cimino-Mathews, said in an expert witness report that Wolber’s choice to “unequivocally” diagnose Ivanova falls “below the standard of care.”
And as for the jury’s response to the case, CBC News says they wrote, “He diagnosed one illness and recommended treatment for another. This was unclear, contradictory and below the standard of care for a reasonably prudent pathologist.”
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Leading Experts Urge Us to Be Proactive
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told us in a previous interview, “because finding a doctor who is up to the latest of information is important.”
RELATED: Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options. Also, in some instances the specific course of treatment is not clear cut. That's even more reason why understanding the potential approaches to your disease is crucial.
RELATED: Burned Out Doctors Make More Mistakes: It's OK To Talk Openly About This With Them
At the National Cancer Institute, there is a patient referral service that will "guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments," Rosenberg says.
Cancer Research Legend Urges Patients to Get Multiple Opinions
Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. "So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility," Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.
RELATED: Mental Health & Cancer: A Third of Patients Aren't Getting the Help They Need
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn't listening to you, or isn't giving you good advice
- You have trouble understanding your doctor
- You don't like the treatment your doctor is recommending, or you're worried about its possible side effects
- Your insurance company wants you to get another medical opinion
- Your cancer isn't improving on your current treatment
Bottom line, being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can, so that you know that you did your best to take control of your health.
How Common Are Misdiagnoses?
Ivanova’s story reminds us of a shocking study about how frequently patients are misdiagnosed. According to the study, published in BMJ, an estimated 371,00 people in the U.S. die every year due to a misdiagnosis and around 424,000 people are permanently disabled. The study said an estimated 800,000 Americans in total suffer “serious harm” due to misdiagnosis every year.
The researchers for this particular study focused on "serious harm," but also noted that less detrimental misdiagnoses were likely occurring on an even grander scale. According to STAT, authors believe the number of diagnostic errors that happen in the U.S. each year could be between 50 and 100 million.
Despite these shocking numbers, most misdiagnoses do not have dire consequences.
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David Newman-Toker, the lead author of the paper, told the outlet, “The risk level just walking through the door in the doctor's office that something horrible is going to happen to you because of a diagnostic error is actually quite low.”
Pushing For A Correct Diagnosis
When it comes to your health, be a little pushy. You know your body better than anyone else. When you see a doctor for a problem, don't hesitate to make sure that your question is fully answered and that you are comfortable with the plan moving forward. From a doctor's perspective, every problem should have a diagnosis, a treatment, a plan for follow-up, and a plan for what happens next if the treatment doesn't work.
As a patient, if you don't feel like each of these four things has been accomplished, just ask! Even if it requires multiple visits or seeing additional providers for a second opinion, always be your own advocate.
Dr. Zuri Murrell, director of the Cedars-Sinai Colorectal Cancer Center, previously told SurvivorNet that healthcare guidelines are meant to do the right thing for the largest number of people while using the fewest resources.
"The truth is you have to be in tune with your body, and you realize that you are not the statistic," he said.
Be Pushy, Be Your Own Advocate… Don't Settle
Dr. Murrell says not every patient will “fit into” the mold, so it's important to “educate yourself and be your own health care advocate.”
“Every appointment you leave as a patient, there should be a plan for what the doc is going to do for you, and if that doesn't work, what the next plan is,” Dr. Murrell said. “And I think that that's totally fair. And me as a health professional that's what I do for all of my patients.”
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Understanding Your Breast Cancer Risk
The risk of developing breast cancer varies greatly from person to person, so it's important to discuss your specific risk level with your doctor. That being said, there are some important risk factors to keep in mind.
In a previous interview with SurvivorNet, Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center, laid out several risk factors for breast cancer including:
- Being a woman: Women are at a higher risk for breast cancer, though men can get the disease too.
- Age: "Breast cancer becomes increasingly more common as women age," Dr. Comen said.
- Family history: "Some people think that breast cancer is only inherited through genes on the mom's side,"
- Dr. Comen said. "But it can also be related to genetic mutations that could be found on the father's side."
- Having had a prior biopsy on an abnormal area: "There are different markers, that if a woman has had a biopsy, it's important that she talk to her doctor about whether those markers are lending themselves to an increased risk of breast cancer," Dr. Comen said. If you've had a biopsy that indicated atypical hyperplasia, for example, you are at an increased risk of breast cancer. Atypical hyperplasia isn't cancer, but it is a precancerous condition that describes an accumulation of abnormal cells in the milk ducts and lobules of the breast.
- Radiation exposure: Cancer survivors who've had radiation to their chest are at an increased risk of breast cancer.
- Lifetime estrogen exposure: "About 2/3 of breast cancer are driven by the hormone estrogen," Dr. Comen said. "So, that means if a woman has had her period at an early age and started to go through puberty at an early age, at seven, eight, nine, and potentially a later age of menopause, means that her lifetime of having had menstrual periods and being exposed to higher levels of estrogen is higher, and therefore her risk of breast cancer is slightly higher."
- Not having a child before age 30 or never having children
- Obesity
- Drinking alcohol
- Lack of exercise: "While there's more research to be done in this area, it looks like if a woman is not exercising, she may also increase her risk for breast cancer," Dr. Comen said.
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Contributing: SurvivorNet Staff
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