Misread Mammogram & Breast Cancer Imaging Lawsuits

How Mammograms and Breast Imaging Work

Breast cancer screening and diagnosis involves several imaging modalities:

- Screening mammogram: A routine X-ray of the breasts performed in women without symptoms, typically starting at age 40 or 50. Two views are taken of each breast (craniocaudal and mediolateral oblique). - Diagnostic mammogram: A more detailed mammogram performed when a woman has symptoms (a lump, pain, nipple discharge) or when a screening mammogram shows an abnormality. Additional views and magnification are used. - Breast ultrasound: Uses sound waves to image the breast. It is particularly useful for distinguishing solid masses from cysts and for evaluating dense breast tissue. It is often used as a supplement to mammography, particularly in women with dense breasts. - Breast MRI: Uses magnetic resonance imaging to produce detailed images of the breasts. It is used for high-risk screening (e.g., women with BRCA mutations) and for evaluating the extent of known cancer. - Tomosynthesis (3D mammography): A newer type of mammogram that takes multiple thin "slices" through the breast, reducing the effect of overlapping tissue. It is particularly useful for women with dense breasts. - Stereotactic or ultrasound-guided biopsy: When imaging identifies a suspicious area, a tissue biopsy is performed to determine whether cancer is present.

Breast imaging is interpreted by a breast radiologist -- a radiologist with specialized training in breast imaging. The radiologist issues a report using the BI-RADS (Breast Imaging Reporting and Data System) classification, which guides the next steps in evaluation and treatment.

Common Mammogram and Imaging Errors

Breast imaging errors can occur at several stages:

• Failure to detect a visible abnormality: The radiologist does not see a mass, calcification, or architectural distortion that is visible on the mammogram. This is the most common type of mammogram error -- a perceptual error.
• Misinterpretation of findings: The radiologist sees the abnormality but misinterprets it as benign when it is actually cancer. For example, calling a malignant mass a benign cyst, or dismissing suspicious calcifications.
• Inadequate views: If the mammogram does not include adequate views of all breast tissue, a cancer in the missed area may not be detected. This is particularly problematic for cancers in the axillary tail or upper outer quadrant.
• Failure to compare with prior mammograms: Radiologists compare current mammograms to prior studies to identify changes. A new or growing mass is more concerning than a stable one. Failure to obtain prior studies can lead to missed new findings.
• Failure to recommend biopsy: When imaging identifies a suspicious finding (BI-RADS 4 or 5), the standard of care requires a biopsy. Failure to recommend biopsy delays diagnosis.
• Failure to recommend additional imaging: When a mammogram is inconclusive, or when the patient has dense breasts, additional imaging (ultrasound, MRI, or tomosynthesis) may be indicated. Failure to recommend additional imaging can miss cancers.
• Failure to communicate findings: The radiologist identifies a suspicious finding but fails to communicate it to the patient or referring physician, or the finding is buried in the report without a clear recommendation for follow-up. [Link to: /radiology-errors/communication-failures]
• Technical errors: Poor image quality, incorrect positioning, or equipment malfunction can produce images that are inadequate for diagnosis.

The Standard of Care for Breast Imaging

The standard of care for breast imaging in New York is based on what a reasonably competent breast radiologist would do under similar circumstances. Key requirements include:

- Appropriate qualifications: The radiologist interpreting mammograms should have training and experience in breast imaging. - Adequate image quality: Mammograms must be of adequate technical quality, with proper positioning and compression. If the images are inadequate, they should be repeated. - Careful image review: The radiologist must carefully review all images, comparing with prior studies to identify changes. - Accurate interpretation: The radiologist must accurately identify and interpret any abnormalities, using the BI-RADS system to classify findings. - Appropriate recommendations: When a finding is suspicious, the radiologist must recommend appropriate follow-up -- additional imaging, short-interval follow-up, or biopsy. - Clear communication: The radiology report must clearly describe the findings, the BI-RADS assessment, and the recommended follow-up. Critical or suspicious findings should be communicated to the referring physician and patient. [Link to: /radiology-errors/communication-failures] - Dense breast notification: New York law requires that women with dense breast tissue be notified, and that the mammogram report include an assessment of breast density. Dense breasts can mask cancers on mammography, and supplemental screening may be indicated.

Failure to meet any of these requirements may constitute negligence. Expert testimony from a breast radiologist is required to establish the standard of care.

BI-RADS: The Reporting and Data System

The BI-RADS (Breast Imaging Reporting and Data System) is a standardized classification system developed by the American College of Radiology (ACR). Every mammogram report must include a BI-RADS assessment category:

• BI-RADS 0 -- Incomplete: Additional imaging evaluation is needed. The mammogram is inconclusive, and additional views, ultrasound, or prior studies are needed.
• BI-RADS 1 -- Negative: No findings. Routine screening recommended.
• BI-RADS 2 -- Benign: Benign findings (e.g., cysts, calcified fibroadenomas). Routine screening recommended.
• BI-RADS 3 -- Probably Benign: Findings are probably benign (less than 2% chance of malignancy). Short-interval follow-up (typically 6 months) is recommended.
• BI-RADS 4 -- Suspicious: Findings are suspicious for malignancy. Biopsy should be considered. (BI-RADS 4 is further divided into 4A, 4B, and 4C based on the level of suspicion.)
• BI-RADS 5 -- Highly Suggestive of Malignancy: Findings are highly suggestive of cancer (greater than 95% chance of malignancy). Biopsy is required.
• BI-RADS 6 -- Known Biopsy-Proven Malignancy: Cancer has been confirmed by biopsy.

When a Mammogram Error Constitutes Malpractice

A mammogram or breast imaging error constitutes medical malpractice in New York when the radiologist or facility deviated from the accepted standard of care and that deviation caused harm. Common breaches include:

- Failure to detect a visible abnormality: A mass, calcification, or architectural distortion was visible on the mammogram but was not detected. - Misinterpretation of findings: An abnormality was detected but misinterpreted as benign (e.g., BI-RADS 2 or 3) when it was actually cancer. - Failure to obtain prior mammograms for comparison: Prior studies are essential for identifying changes over time. - Failure to recommend biopsy: When a finding is suspicious (BI-RADS 4 or 5), the standard of care requires a biopsy. Failure to recommend biopsy delays diagnosis. - Failure to recommend additional imaging: When a mammogram is inconclusive, or when the patient has dense breasts, additional imaging (ultrasound, MRI, tomosynthesis) may be indicated. - Failure to communicate findings: The radiologist identifies a suspicious finding but does not clearly communicate it to the patient or referring physician. [Link to: /radiology-errors/communication-failures] - Inadequate image quality: The mammogram is technically inadequate, but the radiologist interprets it anyway rather than repeating the study.

Under New York law, expert testimony from a breast radiologist is required. A certificate of merit (CPLR 3012-a) must be filed with the lawsuit. [Link to: /medical-malpractice/cancer-misdiagnosis]

The Impact of Delayed Breast Cancer Diagnosis

The impact of a delayed breast cancer diagnosis can be devastating:

- Stage progression: A cancer that could have been diagnosed at stage 1 (5-year survival: 99%) may progress to stage 3 or 4 (5-year survival: 29% for distant metastasis) due to delayed diagnosis. - More aggressive treatment: Later-stage cancer requires more aggressive treatment -- mastectomy instead of lumpectomy, chemotherapy in addition to surgery and radiation. - Spread to lymph nodes and distant organs: Cancer that has spread to lymph nodes or distant organs (lungs, liver, bones, brain) is much harder to treat and significantly reduces survival. - Reduced survival: The most devastating consequence. A patient who could have been cured may face a terminal diagnosis. - Physical and emotional toll: More aggressive treatment causes more side effects -- nausea, fatigue, hair loss, neuropathy, and emotional trauma.

The question of whether earlier diagnosis would have changed the outcome is central to breast imaging malpractice cases. Expert testimony from oncologists is used to establish that the delayed diagnosis caused the cancer to progress and reduced the patient chances of survival. [Link to: /delayed-diagnosis-lawyer/loss-of-chance]

Proving Your Mammogram Malpractice Case

To prove a mammogram or breast imaging malpractice case, you need:

- Radiology records: All mammogram images, breast ultrasound images, breast MRI images, and radiology reports. Prior mammograms for comparison are essential. - Medical records: From the referring physician, breast surgeon, oncologist, and any other treating physicians. - Pathology records: Biopsy results, including the type of cancer, grade, hormone receptor status, and stage. - Expert radiology review: An independent review of the mammogram images by a qualified breast radiologist, who can identify what was missed and whether the standard of care was breached. - Causation evidence: Medical records documenting the stage at diagnosis, the treatment required, and the prognosis -- establishing that earlier diagnosis would have changed the outcome. - Expert testimony: From breast radiologists, oncologists, and breast surgeons.

[Link to: /resources/how-to-get-medical-records-for-a-lawsuit] [Link to: /radiology-errors/proving-radiology-malpractice]

New York Statute of Limitations and Lavern's Law

Mammogram and breast imaging malpractice claims in New York are subject to Lavern's Law, which provides a discovery rule for cancer cases. Under Lavern's Law:

- You have 2.5 years from the date you discovered (or should have discovered) the misdiagnosis to file a lawsuit. - There is an absolute outer limit of 7 years from the date of the negligent act.

This is particularly important in breast imaging malpractice cases, where the missed diagnosis may not be discovered until months or years later -- when the cancer has progressed. For example, if a mammogram was misread in 2021 and the cancer was discovered in 2024, the patient would have 2.5 years from the date of discovery to file.

If the imaging error occurred at a municipal hospital (NYC Health + Hospitals), shorter deadlines apply -- 90 days for the notice of claim and 1 year, 90 days for the lawsuit. [Link to: /hospital-negligence/suing-nyc-h-h]

If the imaging error resulted in death, a wrongful death claim under EPTL 5-4.1 must be filed within 2 years of the date of death. [Link to: /wrongful-death-lawyer] [Link to: /misdiagnosis/laverns-law]

Common Defense Arguments and How We Counter Them

Defense: The cancer was not visible on the mammogram.

Defense attorneys use several arguments in mammogram malpractice cases:

• Our Counter: We have the mammogram images independently reviewed by a qualified breast radiologist, who can testify that the cancer was visible and should have been detected. We also examine whether the correct views were obtained, whether prior studies were compared, and whether additional imaging was indicated.

Defense: The finding was probably benign (BI-RADS 3).

Our Counter: BI-RADS 3 is appropriate only for findings that have a less than 2% chance of malignancy. If the finding had characteristics of a higher suspicion level, classifying it as BI-RADS 3 instead of BI-RADS 4 (suspicious) may constitute negligence. We use expert testimony to establish that the finding should have been classified as BI-RADS 4, requiring a biopsy.

Defense: The patient did not follow up for recommended short-interval follow-up.

Our Counter: If the radiologist recommended short-interval follow-up (6 months), the patient should have been notified and the follow-up should have been tracked. If the facility did not have a system for tracking follow-up, or did not notify the patient, the facility may share liability. [Link to: /radiology-errors/communication-failures]

Defense: The delayed diagnosis did not change the outcome.

Our Counter: We use oncologist expert testimony to establish that earlier diagnosis would have changed the outcome -- that the cancer was at a treatable stage when it should have been diagnosed, and that the delay allowed it to progress to a more advanced, less treatable stage. The loss of chance doctrine may also apply. [Link to: /delayed-diagnosis-lawyer/loss-of-chance]

Compensation Available in Mammogram Malpractice Cases

A successful mammogram or breast imaging malpractice claim in New York can provide compensation for:

• Medical expenses: Additional surgery (mastectomy instead of lumpectomy), chemotherapy, radiation therapy, reconstruction, ongoing treatment, and monitoring
• Lost wages and loss of earning capacity
• Pain and suffering: Physical pain, emotional distress, and loss of enjoyment of life (NY has no cap on non-economic damages)
• Permanent disability and disfigurement: From mastectomy, chemotherapy side effects, and metastatic disease
• Wrongful death damages: If the delayed diagnosis caused death [Link to: /wrongful-death-lawyer]

What to Expect Working with MDLaw Firm

When you contact MDLaw Firm about a potential mammogram malpractice case:

• Free Consultation: We listen to your story and review the basic facts.
• Record Retrieval: We obtain all mammogram images, breast imaging studies, radiology reports, pathology records, and medical records.
• Expert Radiology Review: We engage breast radiologists to independently review the mammogram images.
• Causation Analysis: We use oncologist expert testimony to establish that the delayed diagnosis caused the cancer to progress and reduced survival.
• Litigation: We file within Lavern's Law deadlines (2.5 years from discovery, 7-year outer limit) and handle all aspects of discovery and trial.
• Resolution: We pursue maximum compensation through settlement or verdict.

Frequently Asked Questions

The value of a medical malpractice case in New York depends on several factors, including the severity of the injury, the strength of liability evidence, and the economic and non-economic damages involved. New York is one of the few states with no caps on medical malpractice damages, meaning there is no artificial limit on what you can recover. Below are typical settlement ranges based on injury severity.