Aa
Patient Advocate or medical malpractice attorney
Hi Ladies:
My primary care dr found breast lump 5/11. Mammogram not performed until 5 weeks later because referral was coded as annual mammo not diagnostic mammo. Mammo did not show mass. Ultrasound showed mass. Then report went to wrong dr office. Then dr read me 2 year old mammo report i had provided her. Had excisional biopsy 8/11/11. dr recommended lumpectomy. Diagnosis: extensive ductal carcinoma of comedo type. I asked for 2nd opinion with breast surgeon. Went to breast surgeon who ordered MRI. (first surgeon stated there was no way to tell if cancer in more than 1 duct and that hope radiation "gets it") asked if other breast should have ultrasound as well since has calcifications in it and other side not showing cancer on mammo. Dr says highly unlikely any cancer there. MRI showing increased blood flow area to the other breast. Another mammo and ultrasound now ordered for other breast. Initial oncology consult denied by insurance. I appealed and won. Breast surgeon holding off on surgury to determine if 2nd breast also needs surgury. Primary dr has delayed every referral. Primary dr keeps stating breast cancer is slow growing even tho my turmor was diagnosed as aggressive. It has now been 5 months. I am now having pain in shoulders, back and ribs.Bone scan was denied by insurance. Any recommendations for attorney in So Cal or patient advocate or something? My current surgeon is doing his best to get this done but primary dr keeps delaying the referrals. Thanks for your help!
My primary care dr found breast lump 5/11. Mammogram not performed until 5 weeks later because referral was coded as annual mammo not diagnostic mammo. Mammo did not show mass. Ultrasound showed mass. Then report went to wrong dr office. Then dr read me 2 year old mammo report i had provided her. Had excisional biopsy 8/11/11. dr recommended lumpectomy. Diagnosis: extensive ductal carcinoma of comedo type. I asked for 2nd opinion with breast surgeon. Went to breast surgeon who ordered MRI. (first surgeon stated there was no way to tell if cancer in more than 1 duct and that hope radiation "gets it") asked if other breast should have ultrasound as well since has calcifications in it and other side not showing cancer on mammo. Dr says highly unlikely any cancer there. MRI showing increased blood flow area to the other breast. Another mammo and ultrasound now ordered for other breast. Initial oncology consult denied by insurance. I appealed and won. Breast surgeon holding off on surgury to determine if 2nd breast also needs surgury. Primary dr has delayed every referral. Primary dr keeps stating breast cancer is slow growing even tho my turmor was diagnosed as aggressive. It has now been 5 months. I am now having pain in shoulders, back and ribs.Bone scan was denied by insurance. Any recommendations for attorney in So Cal or patient advocate or something? My current surgeon is doing his best to get this done but primary dr keeps delaying the referrals. Thanks for your help!
Thank you japdip and sue for your quck response. My excisional biopsy indicated i had extensive dcis comedeo type with no invasive seen on 8/11/11. My insurance is horrible its Aetna HMO. To get any procedure you must see your primary and they have to submitt referral to insurance for approval before you can be seen.So now my surgeon requests these tests and forwards to the primary so she can request referral. My insurance doesn't allow him to do referral since he is a surgeon and not my primary doctor. I just got my MRI report yesterday its pretty long but i'll tell you what it says and see if you can figure any of it out
. Findings; Right breast multiple foci of clumped ductal enhancement with suspicious color coding and kinetic curves are seen scattered in the central outer aspect of the upper breast including the follolwing lesions: 7X3 mm focus of suspicious enhancement (IM 88-90) at 12 o'clockl 4 cm from nipple: multiple foci of clumped enhancement in the upper outer breast located 3-6.5 cm from nipple normail right auxillary lymph nodes are present.
Left breast: A fluid filled collection is noted in the mid to anterior breast at 12 o'clock, centered 3 cm from the nipple which measures 21X17X31 mm, compatible with postoperative seroma. Along the superior margin of the fluid collection, there is a 3 to 4 mm area of suspicious enhancement. A 3 mm focuos of suspicious enhancement is noted in the subareolar region of the breast at 6 o'clock, 3 cm from the nipple. Normal left axillary lymph nodes are present.
Impression: Right breast: Multiple small foci of suspiciouos enhancement involving the right breast, predominatly in the central to upper outer regions as detailed above. Given the presense of multiple groups of amorphous or indistinct calcifications seen on outside screening mammograms, these foci may represent malignancy.
Birads: catergory 0. recommend 4 breast diagnostic mammogram and ultrasound for further eval of calcifications as seen on outside mammogram as well as for evaluation for possible on ultrasound to correlate with MRI findings.
Left breast: postoperative seroma in the anterior to middle breast at 12 o'clock with suspicious foci of enhancement along the suerior and inferolateral margins which may represent residual ductal carcinoa in situ. Additional small focua of suspicious enhancement in the subareolar region.
birads catergory 6 known malignancy of the left breast. recommend ultrasound of the left breast to further evaluate the suareolar region if the patient if not undergoing masectomy.
So sounds to me as if i have cancer in right breast as well. I"m not sure what the mammogram or ultrasound will show that the MRI did not show. My initial plan was lumpectomy on the left with radiation but now thinking maybe i need bilateral masectomy and be done with it. I will definately be changing my primary physician hoping to get her to do these last referrals and never see her again.
Thanks for listening ladies! I appreciate all you do on these boards.
. Findings; Right breast multiple foci of clumped ductal enhancement with suspicious color coding and kinetic curves are seen scattered in the central outer aspect of the upper breast including the follolwing lesions: 7X3 mm focus of suspicious enhancement (IM 88-90) at 12 o'clockl 4 cm from nipple: multiple foci of clumped enhancement in the upper outer breast located 3-6.5 cm from nipple normail right auxillary lymph nodes are present.
Left breast: A fluid filled collection is noted in the mid to anterior breast at 12 o'clock, centered 3 cm from the nipple which measures 21X17X31 mm, compatible with postoperative seroma. Along the superior margin of the fluid collection, there is a 3 to 4 mm area of suspicious enhancement. A 3 mm focuos of suspicious enhancement is noted in the subareolar region of the breast at 6 o'clock, 3 cm from the nipple. Normal left axillary lymph nodes are present.
Impression: Right breast: Multiple small foci of suspiciouos enhancement involving the right breast, predominatly in the central to upper outer regions as detailed above. Given the presense of multiple groups of amorphous or indistinct calcifications seen on outside screening mammograms, these foci may represent malignancy.
Birads: catergory 0. recommend 4 breast diagnostic mammogram and ultrasound for further eval of calcifications as seen on outside mammogram as well as for evaluation for possible on ultrasound to correlate with MRI findings.
Left breast: postoperative seroma in the anterior to middle breast at 12 o'clock with suspicious foci of enhancement along the suerior and inferolateral margins which may represent residual ductal carcinoa in situ. Additional small focua of suspicious enhancement in the subareolar region.
birads catergory 6 known malignancy of the left breast. recommend ultrasound of the left breast to further evaluate the suareolar region if the patient if not undergoing masectomy.
So sounds to me as if i have cancer in right breast as well. I"m not sure what the mammogram or ultrasound will show that the MRI did not show. My initial plan was lumpectomy on the left with radiation but now thinking maybe i need bilateral masectomy and be done with it. I will definately be changing my primary physician hoping to get her to do these last referrals and never see her again.
Thanks for listening ladies! I appreciate all you do on these boards.
Get a new doctor! You are your own best advocate. Feel free to bit*ch as loud and as long as it takes to get your way. Do NOT wait on them!
There is no reason your Breast Surgeon couldn't refer you for anything that is necessary at this point. I'm not sure I would be waiting for anything ... I also believe that something malignant in the "other" breast would be quite unusual although possible. I don't know what type of INS. you have but it doesn't seem to be the best by any means. There are laws concerning pt. rights when it comes to Breast Cancer including tests and treatment. I would certainly find myself another Primary Care Physician unless there are factors that are not stated. Excisional Biopsy and Lumpectomy can be terms used for the same type of procedure. In the Path. report there may have been some mention of the margins of the tissue that was excised. You don't mention your age but a screening Mammogram which is often followed by an Ultrasound can be done even without a Dr.s order and a referral is never necessary. These tests are most always done on both breasts. You state "extensive" but not "invasive" ... I'm curious as to exactly what the term "extensive" means in this case. It's a term that I can't say I've seen used in reports until now. I'm not sure what an Attorney would do in your case as no malpractice is evident as far as I can see. You might consider contacting the American Cancer Society and state your case there .... they may have a recommendation for you but from what I can tell it's 100% up to your Physicians to get things done and that includes issues with your Ins. Co. Best of Luck ........
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