"Doctor, I have this lump in my right breast...right here. I think it's grown over the last month. What do you think?"

This is usually how a case starts. How it finishes depends on many factors. Here's what I mean...

When a patient has a specific complaint, the doctor is obligated to examine the lump and make a clinical evaluation. The doctor should have already taken a thorough history to learn whether any blood relative had any type of cancer- especially breast cancer. It will be important for the doctor to know whether your breasts are usually cystic (have many lumps naturally) or whether this is an isolated and new finding. It is also important to know if you're also having your period, as that can sometimes exacerbate normally cystic breasts.

There are many options available to the doctor at this point. They can simply tell you to watch and observe the lump to see if it gets bigger. They can refer you to a breast surgeon for an evaluation and possible needle biopsy or a lumpectomy. They can send you for x-rays, a sonogram and/or a mammogram. Depending upon what choices the doctor makes will determine what your next step will be as far as evaluating your lump.

Many women will choose to immediately see the breast surgeon. The breast surgeon will perform a physical examination of your breasts while sitting up, and also lying down. In some cases the surgeon will want to try and put a needle into your breast, in the area where your lump is. This will help the surgeon determine if the lump is solid, is a fluid-filled cyst, or something else entirely. Depending upon where the needle is placed a surgeon can sometimes get tissue or fluid to send to a lab for evaluation under a microscope.

The bottom line here is that if you feel a lump in your breast, do not let a doctor dismiss it without getting tests to evaluate it, and it might be wise to get a second opinion. Certainly if the lump gets bigger, you must follow up with a specialist in order to properly evaluate it. Keep in mind that certain tests, such as sonograms and mammograms have something called "false-positives" and "false-negatives." This means that no test is perfect and even though a mammogram shows your breast as "normal" there is a slight possibility that the reading is wrong. That's why you must be extremely vigilant about the lump and must insist on following it up with your doctor and possibly a breast surgeon as well.

The most common kind of mistakes and errors that medical malpractice lawyers see in breast cancer cases is the failure to recognize a tumor on an x-ray or mammogram. The failure by a doctor to recognize an obvious tumor represents a departure from good medical practice. The question then becomes how has the delay in diagnosis affected your injuries? Here's what I mean.

As a result of the delay has your cancer spread to other parts of your body? If it had been timely diagnosed, was it small and isolated to a small part of your breast? 

Now when your cancer has finally been detected, has it spread beyond your breast and entered your lymph nodes? The cancer doctors have different terms used to "Stage" a cancer. Stage 1, 2, 3, 4. Stage 1 is usually a localized cancer that is amenable to getting rid of it entirely with surgery. Stage 4 typically means it has spread throughout your body and your treatment options, if any, may be extremely limited.

From a lawyer's standpoint, it is important to know what additional injuries you suffered as a result of any delay in diagnosis. In other words, how would your condition have been different today, compared to what it is now, had you been properly and timely diagnosed. That's the key to beginning to establish your damages in a potential case.