Odd question if u don't mind...

Chelee

Odd question if u don't mind...

Chelee

Since my orignal MRM in 2005 I have had problems with a seroma.  So I had another ultrasound not long ago to check on it. When reading the report by the radiologist it says:

"Benign ulrasound-guided FNA biopsy of right breast, Octber 31,
06.  Benign mastectomy of right breast, January 3, 06.  Malignant
core biopsy of the right breast December 12, 05.

It mentioned the seroma that was drained...but the next thing it says is BENIGN mastectomy of right breast.  (Benign?)

Why does it say BENIGN mastectomy of right breast?  I don't get it?  That's the breast I HAD the mass in.  It even mentioned the core biopsy is malignant.  So since we KNOW the biopsy was cancer...how come when they remove my breast its considered BENIGN? If there was cancer in that breast...I don't see HOW they can call it a benign mastectomy?  I would think it was a typo but I've seen it on a couple other reports.  (Could it be because the mass was the actually cancer...but the REST of the breast WAS benign?  (Strange?) I called my surgeons nurse today but their out till next Thrusday.  Anyone know why its worded this way?

Chelee

Chelee

Ok...guess that answers that.  lol

Chelee

sherryw

Chelee

 I just wonder if they are using the word benign, meaning that the breast is not there.  That is the only thing I think it could be. Did you get an original pathology report when you had the mastectomy or biopsy?

Sherry 

Chelee

Sherry,  Thanks for the reply.     Yes, I did get a pathology report and it did say I had DCIS.  That's why I was curious about the wording on my Ultrasound reports.  These reports are about a year and half since orignal DX and I couldn't help but notice the wording.  I didn't know if it was a typo...or what?

But maybe its as simple as since they cut out the mass...the rest of the breast is considered benign?  Over the two years I've read alot of posts from women on several boards and have never ran across this.  I haven't been back to my surgeon to ask him why it says that.  Its trivia...but I just want to know why its worded like that?   You might be right too...that could be exactly the reason?  Obviously its not something many have seen since there were no replies.  lol  That's why I laughted and said "That answers that".  haha  Thanks so much Sherry. 

Chelee

AlaskaAngel

Chelee,

Whatever it actually is, it is poorly worded and too easily misinterpreted. I hope you will post any answer you get from your doctors. I can't tell from your signature history if part of the problem could be that when they listed the sequence of events in their report, they mixed up a left versus right, and I don't quite recall your full history offhand. It sounds like the latest results were fine so nothing to worry about in that respect -- but I think it is possible that there is an error in the remainder and that questioning it makes good sense.

Since diagnosis in 2001 by core biopsy, I've had one report done in Alaska with a major error, and one in Seattle with a major error. Neither one worried me at all because they were obvious errors. But I mention this because it does happen. It pays to always get copies of your tests and to question anything you don't understand.

AlaskaAngel

Chelee

AlaskaAngel,  Due to *all* the procedures I've had since my orignal surgery I thought they mixed something up as you suggested. I had my first & orignal MRM on 1-3-06 on the right side...and my phophylactic simple mastectomy of the *left* breast on 3-5-07 which the only thing found at that time was hyperplasia.  So I thought *maybe* since the left breast was considered pretty much benign, they switched the two by accident. (Typo)  But that can't be the case because the actually date of my first surgery to remove the mass WAS 1-3-06 as its put in my report.  So that's why this throws me a bit...to say the core biospy on 12-12-05 WAS malignant...but benign breast mastectomy on 1-3-06 can't be right because that was the actually date of my surgery to remove the tumor.  Makes absolutely NO sense to me at all?  (Again, unless they consider the mass/tumor malignant & once its removed...the REST of the breast is now considered benign since the cancer is gone?  (Who knows?)

I had a few people tell me just to forget about it but I can't...drives me nuts.  I'm glad that you support the idea that I look into this and find out *why* its written like that.  I'm good at getting copies of everything from all my doctors...I go over all of them.  This has been one of the strangest things I've found on a report.  I've called my surgeon's nurse several times to ask her about this and so far I haven't been able to get her on the phone.  It must be due to the holidays. I will find out why its worded like that...I have to know.  (I WISH it was benign!) Its probably a typo and it keeps showing up on my repeat ultrasounds because someone just copies what's said on my prior reports?  When I find out I will post it.  Thanks for your input Alaska.

Chelee

AlaskaAngel

Chelee,

I too had a seroma that stuck around for quite a while originally. My surgery was in Seattle, but afterward I had a follow up chest CT in Alaska. By chance I had met the radiologist who made the mistake on that CT. He was temporarily subbing for the regular rads doc. He was a nice guy, but he reported that the seroma was a prosthesis. I reported the error to my PCP, who then called my surgeon in Seattle, who is topnotch. Although as I understand it the conversation was rather remarkable (and I wish I could have heard it firsthand), in a nutshell the surgeon was quite clear in stating that my surgery involved NO prosthesis.

One never knows what such an error could lead to when later doctors are dealing with me as a patient, whether one might decide (in not realizing the error) that certain more precise imaging tests should be avoided, for example--which might mean I would be limited to a less helpful test. The whole intent of imaging is so that doctors are better able to make good decisions about how to further investigate OR NOT, and about how to treat.

The second error I caught from reading my reports was done in Seattle. It was more serious since it indicated that both breasts were affected, which is not the case. There can be all kinds of confusion in regard to future care based on someone later reading that report and not knowing it is in error. I phoned the place where it had been done and asked to speak with the radiologist personally. Doctors are busy people and it took persistence to get past the rank and file, and eventually he returned my call and I explained what the problem was. He had the images in front of him by that time for the call, and he realized I was correct. He apologized and said he would see to it that what is called an "addendum" was then attached to that original report. In that addendum it clearly states that the original report was in error and then includes the correction. He also cc'd the correction to my oncologist. I'm sure it was not pleasant for him because he respects the onc quite a lot, but that was done at his own suggestion and I think it showed good sense and integrity. He also mailed me a copy for my records.

Perhaps these things happen so often that when my onc got the original report he let it pass since the report itself was a good one with no indication for other treatment. But I prefer to correct any confusion to minimize any difficulty there could be among doctors scattered in different places who make decisions about my care over time. I do think it is worth it and can really pay off.

I have my own guess about your report, and would be interested in hearing what you learn tomorrow (Thursday).

AlaskaAngel

Chelee

AlaskaAngel,  Wow, that's quite a story. Those errors can cause problems in the long run as you pointed out.  I'm like you in that I want them corrected.  Especially when we have to deal with a disease for the rest of our lives which means we will constantly be seeing doctors and seeing new ones.  Those NEW doctors we see need to be able to depend on *correct* information or we might not get the needed treatment we need at the time due to one of those errors. 

I'm impressed with your persistent's to get *both* errors corrected as I'm finding it isn't as easy to FIX the problems on paper as I thought it was going to be!  Its turned into another major headache for me.  It took forever due to the holidays to get ahold of my surgeons nurse.  I asked her about my report saying I had a *benign* mastectomy.  She immediately said "Oh, they must of mixed it up with the *other* side". (since I did have a prophylactic simple mastectomy on the other side.)  She blew it off like it was no big deal.  I explained to her its on two of my ultrasound reports & I want it corrected since my right breast WAS malignant...NOT benign. I asked if maybe it was written that way because once they removed the malignant mass...they consider the rest of the breast benign?  She said, "No...that's not it....its just a typo so don't worry about it".  She said its no big deal. (Yea, not to her!)

She didn't bother to get out a copy of my report to see what I'm talking about & expects me to forget about it.  I told her I want a correction made...an addendum added since I have a right to do that.  I have to go down there in person next week for my appt so I will deal with it then since noone seems to think its very important.

So all my thoughts about why it might be written like that were no more then a typo if you ask the nurse?  (Fustrating.)  I had a 3.5 cm tumor in that breast and it was malignant.  The reports all say malignant core biospy and benign mastectomy on the right side...yet they DIDN'T notice nor do they care now that I pointed it out to them.  I can't help but agree with you that these errors happen so often that the doctors let them go especially if the report is good.  I've found lots of small errors but this one I want correct. 

What was your quess about the mistake?  (Typo?) 

Chelee

bevnurse

Here is a way to get them to correct that report. Demand to know why they did a mastectomy on a healthy breast. Ask them if that means the + biopsy was actually done on the left breast? And then ask them if that means they have not removed the cancerous breast???

There's a medical-legal nightmare for them to work through!!! 

Chelee

bevnurse,  What a great idea.  That's a great way to present it to them...that should get their attention.  Thanks SO MUCH for your post...if that doesn't get it fixed asap, I don't know what will. 

Chelee

AlaskaAngel

Chelee,

Ignore the nurse who tried to minimize the concern, other than to remember in the future that she may not be 100% reliable for answers. I do think her response is fairly typical and unfortunate. Until medical personnel have actually had to go through comprehensive treatment they don't recognize the problems that crop up all through treatment through the years from just those kinds of errors.

Recently I had my annual physical exam by my PCP. He's very professional. But even so, when we were talking about a procedure I'd had once that he finally just went through himself, it was pretty funny because he had this look on his face of genuine surprise and pain about his own experience with it. They just don't truly "get it" until they've "had it".

Try your best to handle it with tact. If you have to, write a letter directly to the radiologist who signed the report, asking for a correction.

A.A.

Chelee

AlaskaAngel,  That's really a big part of it...these doctors don't have a clue until they have had it done to them.  Plus I'm sure errors on medical records happen far to often and most patients don't even get their records to know there are mistakes...let alone if they DID have them they would probably think its no big deal or not worth the hassle to correct it.

But in the long run its very important to me that all my records are correct and I know I'm not the only one that feels that way.  As you obviously agree and have been through it.  Your one of the few to go the distance to have it correct which is not always easy as you know all to well from experience. 

I made some calls to the my surgeons nurse to get this corrected but she keeps telling me she will take care of it.  She usually does what she says.  But I've called her 3 times over this same issue and decided to write a letter to my surgeons office.  I even went to the post office and sent it certified mail and return reciept.  That way they HAVE to sign for it and can't say they didn't receive it.  So hopefully that should take care of it.  I think they will take it more seriously now that its in writing.  I will find out Friday if it was taking care of since I have to see my onc that day. 

Chelee

AlaskaAngel

Hi Chelee,

I hope your visit with your doc today is a good one and that there is genuine acknowledgement from him/her and not just another indefinite promise or brush-off. Again, if you don't get results you might want to send a letter directly to the radiologist who signed the report. You or your insurance pay several hundred dollars for these professional-level services. I don't know how you feel about that, but I want my money's worth.

Although it is your doctor and his staff who ordered the report in the first place and who are the ones to talk with you about the results (and have an obligation to respond to your request), I also know that if they are part of an assembly line operation the problem is likely as you say, much too common. Some places outsource the transcription work overseas or to the cheapest outfits in the USA where the workers don't have the training or time or ability to correctly translate what the radiologist is saying, and when that is true the radiologist ends up spending too much time trying to get errors corrected and not enough time just reading the imaging studies in the first place. But it is still the radiologists who are  responsible for verifying the accuracy of the report and for correcting any errors by making an addendum to it.  

AlaskaAngel