The Death of Mammography
Cancer has been with us since the dawn of mankind. At one time people thought cancer was a product of industrialization, but archaeological finds would reveal that the oldest specimen of cancer found in a human was discovered in the remains of a female skull sometime during the Bronze Age between 1900 and 1600 BC. Breast cancer has been documented since the 17th century BC, though back then it was treated with pretty barbaric means. The history of cancer, and breast cancer in particular, is varied, and can be found in "The Death of Mammography".
Can We Save The Mammogram?
The art and science of mammography are not infallible even under the most carefully controlled conditions, however a reduction in mortality from breast cancer has been exhaustively proven. The reason: early diagnosis. Even though the signs of early breast cancer can be very subtle, mammography is a woman's best bet for the survival of breast cancer.
In 2004, the American Cancer Society reports that 215,990 new breast cancer cases in women will be diagnosed, and 40,100 will die of it. Women are encouraged to get a mammogram every one-two years, after the age of 50. However, women have been misled, and are under the false impression that mammography is foolproof, and if the exam is done early enough and often enough, breast cancer can be detected, treated, and contained. In all cases, even under the most optimal circumstances, research has shown that as high as thirty percent of breast cancers are not visualized on mammography. It does not mean the radiologist is negligent. It means that mammography has become the most frequent modality in lawsuits claiming malpractice against radiologists.
In February 2004, in Florida, a jury found two radiologists liable of failing to diagnose a plaintiff's breast cancer. Though three radiologists compared and read three mammograms as normal, nine months later the woman found a lump, which turned out to be malignant. She sued; she had an aggressive attorney, an empathetic jury, and won.
The leading cause for medical malpractice claims is failure to diagnose breast cancer on a mammogram. Experts in the field say such lawsuits mainly stem from serious misconceptions about the ability of mammograms to detect cancers and from an assumption that the radiologists who read mammograms should be able to see things that may be discernible only in hindsight. Leonard Berlin, M.D., chairman of radiology at Rush-Presbyterian-St. Luke's Medical Center in Chicago says the public has a highly inflated view of the accuracy of mammography. Radiologists across the country are faced with the prospect of litigation and the high cost of malpractice insurance, and are now refusing to read mammograms. Radiology residents are passing over specializing in breast imaging, and over 700 mammography centers across the United States have closed their doors in the last few years.
The current medical liability crisis in this country is real and is not going to magically disappear any time soon. One of the original goals of this book was to present an unbiased account of decreasing access to health care services, specifically mammography. Sources from all the players involved, physicians, liability insurers, and plaintiff and defense attorneys, were contacted and questioned regarding various aspects of the issue. Surprisingly or not several malpractice plaintiff attorneys declined to give interviews. One in particular answered questions presented to him, then reneged. In fact, he gave an honest opinion regarding the crisis, which most plaintiff attorneys believe is non-existent, and stated that "if mammography dies it will not be because of the lawsuits arising out of the destruction of the lives of those women and their families that have been betrayed." The Association of Trial Lawyers of America (ATLA) was also contacted for interviews; no response was forthcoming. This is one reason it made it difficult to present an unbiased view. No one from the ranks of plaintiff trial lawyers attempted to back their assertion of protecting America's malpractice "victims."
However, a former trial attorney, currently a law professor, gave some insight, closely paralleling those of the ATLA, into the current malpractice liability issue. It appears a moot point in any case, because these lawyers are very powerful, are set apart from most industries, and pretty much a law unto themselves. That does not mean it cannot change, however.
The information is presented in the book how it was researched. By that is meant as efficient and unfettered as possible; sources were checked for reliability, and a representation of all players was invited to participate.
However, there is such a plethora of information about mammography and breast cancer and their various aspects, each topic could not possibly have been written about comprehensively in one book, and probably would require volumes. The intent was to present an overall view of the most important aspects of breast cancer and mammography, and their relationship to malpractice litigation and the decrease in access to mammography.
There is a breast cancer crisis in this country, and unless something is done about it, it will be too late to save mammography, the only screening test currently available for detecting breast cancer.
Can We Save The Mammogram?
The art and science of mammography are not infallible even under the most carefully controlled conditions, however a reduction in mortality from breast cancer has been exhaustively proven. The reason: early diagnosis. Even though the signs of early breast cancer can be very subtle, mammography is a woman's best bet for the survival of breast cancer.
In 2004, the American Cancer Society reports that 215,990 new breast cancer cases in women will be diagnosed, and 40,100 will die of it. Women are encouraged to get a mammogram every one-two years, after the age of 50. However, women have been misled, and are under the false impression that mammography is foolproof, and if the exam is done early enough and often enough, breast cancer can be detected, treated, and contained. In all cases, even under the most optimal circumstances, research has shown that as high as thirty percent of breast cancers are not visualized on mammography. It does not mean the radiologist is negligent. It means that mammography has become the most frequent modality in lawsuits claiming malpractice against radiologists.
In February 2004, in Florida, a jury found two radiologists liable of failing to diagnose a plaintiff's breast cancer. Though three radiologists compared and read three mammograms as normal, nine months later the woman found a lump, which turned out to be malignant. She sued; she had an aggressive attorney, an empathetic jury, and won.
The leading cause for medical malpractice claims is failure to diagnose breast cancer on a mammogram. Experts in the field say such lawsuits mainly stem from serious misconceptions about the ability of mammograms to detect cancers and from an assumption that the radiologists who read mammograms should be able to see things that may be discernible only in hindsight. Leonard Berlin, M.D., chairman of radiology at Rush-Presbyterian-St. Luke's Medical Center in Chicago says the public has a highly inflated view of the accuracy of mammography. Radiologists across the country are faced with the prospect of litigation and the high cost of malpractice insurance, and are now refusing to read mammograms. Radiology residents are passing over specializing in breast imaging, and over 700 mammography centers across the United States have closed their doors in the last few years.
The current medical liability crisis in this country is real and is not going to magically disappear any time soon. One of the original goals of this book was to present an unbiased account of decreasing access to health care services, specifically mammography. Sources from all the players involved, physicians, liability insurers, and plaintiff and defense attorneys, were contacted and questioned regarding various aspects of the issue. Surprisingly or not several malpractice plaintiff attorneys declined to give interviews. One in particular answered questions presented to him, then reneged. In fact, he gave an honest opinion regarding the crisis, which most plaintiff attorneys believe is non-existent, and stated that "if mammography dies it will not be because of the lawsuits arising out of the destruction of the lives of those women and their families that have been betrayed." The Association of Trial Lawyers of America (ATLA) was also contacted for interviews; no response was forthcoming. This is one reason it made it difficult to present an unbiased view. No one from the ranks of plaintiff trial lawyers attempted to back their assertion of protecting America's malpractice "victims."
However, a former trial attorney, currently a law professor, gave some insight, closely paralleling those of the ATLA, into the current malpractice liability issue. It appears a moot point in any case, because these lawyers are very powerful, are set apart from most industries, and pretty much a law unto themselves. That does not mean it cannot change, however.
The information is presented in the book how it was researched. By that is meant as efficient and unfettered as possible; sources were checked for reliability, and a representation of all players was invited to participate.
However, there is such a plethora of information about mammography and breast cancer and their various aspects, each topic could not possibly have been written about comprehensively in one book, and probably would require volumes. The intent was to present an overall view of the most important aspects of breast cancer and mammography, and their relationship to malpractice litigation and the decrease in access to mammography.
There is a breast cancer crisis in this country, and unless something is done about it, it will be too late to save mammography, the only screening test currently available for detecting breast cancer.
posted by RJackson at 2:44 PM
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