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Misdiagnosis in Breast Cancer and Other Diseases

Posted Jul 21 2010 12:41pm

There is a scary article in yesterday's New York Times by Stephanie Saul about incorrect diagnoses in breast cancer. Unfortunately, not only is there misdiagnosis in breast cancer, but other types of pathological diagnosis are frequently wrong. Having reviewed countless muscle pathology slides for patients I have found that the majority from across the U.S. were misdiagnosed. General  pathologists just do not have training in all areas.

The article quotes Dr. Michael Lagios, whom I know, and is an excellent pathologist and physician. "In 2007 and 2008, he reviewed 597 breast cases and found discrepancies in 1412 of them, including 27 cases of ductal carcinoma in-situ (D.C.I.S.)"

The article gives examples of three women who were told they had breast cancer but  later found not to have it. They unfortunately had surgery, radiation, or chemotherapy or all of these. I was amazed that one of pathologists, who made a wrong diagnosis, was not even board-certified. I was not aware that any hospital would allow a member on their staff to be either not board-certified or board qualified. So now not only should patients check to be sure their doctors are board-certified, but also the pathologist if his or her services are needed. In addition, and I have written and said this repeatedly, a second pathologist's opinion must be obtained from a reputable center such as the Armed Forces Institute of Pathology.

One of the reasons that I finally decided to close the Center for Handicapped Children, that I founded and directed in San Francisco for 23 years, was that I was having to send the tissue from the muscle biopies we obtained to Professor Caroline Sewry in London. As a good friend, she did not charge me. The only other place I could have sent the tissue was the Mayo Clinic, but there would have been a charge which Medi-Cal or insurance companies  would not have paid. Muscle pathology as breast pathology must be processed and interpreted by someone who has long experience in reviewing the tissue slides. Not every hospital is equipped to properly process and review tissues for specific disorders.

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