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Medico-legal Aspects of Delay in Diagnosis of Breast Cancer

Ian S Fentiman

Delayed diagnosis of breast cancer forms a substantial part of medical litigation and may sometimes result from communication failure in the multidisciplinary team. Review of such cases may result in improved patient pathways as a result of lessons learned. There is evidence that delay may significantly worsen prognosis. For a claimant to successfully pursue a case it is necessary for the medical experts to confirm that both negligence and causation have occurred. Methods are available whereby likely tumour size at the time of negligence and likelihood of axillary nodal involvement can be estimated. There are now various prognostic models that can be used to estimate the impact of delay on prognosis but as a result of improvements in treatment many cases will not meet the criteria for causation.