Surgeon Question

bruinjamie21

Hello fellow high risk ladies. So, I've been seeing a surgeon for yearly preventative screening/MRIs for about 5 years. (I'm 43). This surgeon came highly recommended by my OBGyn and I really like her, aside from the fact that she seems more conservative than I am and doesn't think I should consider preventative Double Mastectomy and prefers the extra screening approach.

Well... I just saw a friend of mine this week who was diagnosed with early stage breast cancer a couple years ago that has now returned AFTER the double mastectomy and spread everywhere. She and I go to the SAME surgeon. The surgeon's husband is also the pathologist. And I just found out she's SUING them both for mis-diagnosing the tumor type.

I'm set to see my surgeon for an MRI next month. If you were me, would you immediately look elsehwere? The thought of starting over with someone new is a bit overwhelming but then again so is the thought of "missing" something and not being here to see my kids' grow up. If you were me, what would you do?

AliceBastable

Unless your friend can prove gross negligence, she won't win except on pity points with a jury. It's cancer. It can recur or metastasize, even with a mastectomy. If that didn't happen to some patients, cancer wouldn't be any scarier than tonsillitis.

moth

Yes, even with a mastectomy, all the tissue is not removed and a mastectomy doesn't prevent a metastatic recurrence. All it takes is an individual cell to escape through blood or lymph and take up residence somewhere else. People die from from metastatic cancer after having BMX for early stage. It happens. People can even die from metastatic breast cancer after having a prophylactic BMX. Remember the risk reduction is not 100%...

The pathology spouse - that would depend on the actual set up. Do they both work for a large cancer center? Or is this is a smaller private practice? Because in house labs and in house pathology in small places give me pause - look up the Dr Death podcast about an oncologist who was misdiagnosing people with cancer and providing unnecessary treatments. But in a bigger faciilty, it happens. People marry in certain professions and end up working at same place.

Since you're having MRI, there will be a presumably impartial diagnostic radiologist to review that imaging & there's very little for a surgeon to screw up at this screening.

Salamandra

How close is your friend? I don't think I would be able to continue with a doctor that a very close friend felt wronged by, whether or not my friend was correct in her judgment.

How much do you trust your friend's judgment? I have a couple of people in my life - very few - whose judgment I would trust above my own in certain matters. They aren't necessarily my closest friends, but they have my deepest respect. If it were one of them, I also would look for a different doctor.

But if it's not a very very close friend, and not someone whose judgement you have great trust in, I wouldn't necessarily let this color your decision. Anyone can sue anybody for anything. People dealing with the emotional upheaval of a serious diagnosis sometimes look desperately for someone/anyone to blame, and there are lawyers who target exactly these vulnerable people. Great doctors get sued.

I agree with Moth about the pathologist spouse. In a large cancer center it wouldn't give me pause, but in a small set up it would.

I wonder what your other options are? If you are in a small town, you may be more limited than if you're in a major city. On the other hand, reputations may also spread faster in a small town, and it may be worth going back to your ob gyn and checking with her if she's learned anything in the last few years that would give her pause when recommending this surgeon.

I can definitely see how this would be upsetting and alarming, but I think you can take your time to decide on next steps. Even if you get your MRI with this doc, you can still get a second opinion reading for the pathology.

Rubytoos

So the surgeon orders your MRI's, and then a radiologist reads them, and also the surgeon, right? No one can diagnose a malignancy 100% from images, much less type, but they can develop highly educated guesses. The biopsy and pathology is where the rubber meets the road. So if you reach a point where a biopsy is needed ask for a second opinion on any pathology or send it out to a top tier cancer center. Just because the surgeon is related to the pathologist who misdiagnosed your friend does not mean either individual is per se incompetent. Mistakes do happen. Always good to get another pathologist involved if there are questions.