Gorovitz & Borten, P.C.
Attorneys at Law

550 Cochituate Road, Suite 25
Framingham, Massachusetts
Tel: (781) 890-9095
Failure to Screen for
Breast Cancer
Existing guidelines for breast cancer risk assessment and potential interventions
are applicable to most women over the age of 20. Annual clinical breast
examination by a medical provider starts at age 20 even in the absence of any risk
factors for breast cancer. Annual clinical breast examinations should continue
regardless of age by any medical examiner providing primary breast care to women.

High risk patients for developing breast cancer such as those with a strong family
history require special screening for breast cancer. Women with a positive family
history of breast cancer have an increased risk of developing breast cancer during
their lifetime. Familial breast cancers constitute 15% to 20% of all breast cancers.
One half of women with familial breast cancer history have a mutation in a heritable
gene called BRCA1 and BRCA2. Women who carry a BRCA1 or BRCA2 gene
mutation are considered to be at a higher risk of developing breast and ovarian
cancer. The BRCA1 and BRCA2 serve as susceptibility genes to promote
tumorigenesis. Patients with BRCA1 or BRCA2 gene mutations should undergo
genetic counseling and be screened with breast MRI scans which have shown to be
superior over other screening modalities.  Clinical breast examinations on these
high risk patients should be performed twice per year.

Screening mammograms are performed on women who have no signs or symptoms
indicative or suspicious for breast cancer.

The evaluation of a breast complaint requires a diagnostic work-up. A diagnostic
work-up is more intensive than a screening evaluation based on risk factors for
breast cancer. Screening for breast cancer includes:

  • Breast self-examination
  • Breast examination by medical provider
  • Mammography
  • Magnetic resonance imaging (MRI)

Screening mammography is the preferred examination for asymptomatic woman at
risk for breast cancer. Current recommendations for screening mammography in
women without a family history of breast cancer include a baseline mammogram
between ages 35 and 40 followed by a biennial mammogram between ages 40 and
49 and annual mammograms after age 50.

If a screening mammogram reveals any change from a previous mammogram, then
a diagnostic mammogram with additional images and at times magnified images are
required. Comparison with previous mammograms are of paramount importance.
The appearance of microcalcifications on a screening mammogram must be further
investigated. The size, number, location and configuration (clusters) of
microcalcifications requires further diagnostic studies.

It is extremely important to understand that a mammogram is not a fail-safe
technique. A patient may have a breast cancer and the mammogram be negative
because it fails to show a radiographic detectable abnormality.

Interpretation of mammograms have been standardized. The American College of
Radiology (ACR) has established a Breast Imaging Reporting and Data System (BI-
RADS) to facilitate comparison between mammographers. BI-RADS assessment
categories are as follows:

  • Category 0:  Need additional imaging evaluation
  • Category 1:  Negative
  • Category 2:  Benign finding, noncancerous
  • Category 3:  Probably benign finding, short interval follow-up suggested
  • Category 4:  Suspicious abnormality, biopsy considered
  • Category 5:  Highly suggestive of malignancy, appropriate action needed

The higher the BI-RADS, the greater the risk that a mammographic finding will be
associated with a breast cancer on biopsy. Computed Tomography (CT), Magnetic
Resonance Imaging (MRI) and Ultrasonography are also adjuvant methods of
screening for breast cancer. The higher the risk for breast cancer, the more
procedures may be required to screen a particular woman.

If you (or a loved one) are suffering from complications due to a failure to timely
diagnose, delayed diagnosis or misdiagnosis of  breast cancer, or the
recommended screening guidelines were not followed, let
Dr. Borten and our
Boston area medical malpractice attorneys at Gorovitz & Borten evaluate your
case. We can help you assert your rights and get the compensation you deserve.
Contact Information
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possible), please contact us by phone, fax or e-mail with your question or concern.

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