When Your Mammogram is Normal – But You Feel A Lump in your Breast

Where does the chance to find breast cancer earlier get missed?

• A screening mammogram was ordered for a lump. The order did not mention the lump. The radiologist had no reason to look closely at one spot or add an ultrasound.
• The normal result was treated as the final answer. The lump was still there, but no ultrasound was ordered. The chart may say “mammogram negative” with no plan for the lump.
• You told the imaging center about the lump, but the exam was still ordered as a screening mammogram. Many centers will switch to a diagnostic exam when a patient reports a lump. The records should show whether that question was asked and what was done.
• The screening mammogram report said your breasts were dense, and you had a lump, but no one added an ultrasound. Dense tissue plus a lump is a strong reason for a second look.
• You came back and said the lump was still there or growing. You were reassured because of the earlier normal mammogram. No further imaging was ordered.

What should I check in my own medical records?

You can answer most of these from memory, your patient portal, or your records.

• Did you tell a doctor or nurse about the lump before the mammogram?
• Does the mammogram report say “screening” or “diagnostic” at the top?
• Does the report mention the lump or where it was?
• Did the report say your breasts were dense?
• Was an ultrasound ever done of the lump?
• After the normal result, did anyone recheck the lump or set a date to return?
• How much time passed between your first report of the lump and your biopsy?

Did the delay in diagnosis change the outcome?

A missed step alone is not enough for a claim. The question is whether proper imaging would likely have found the cancer at an earlier, more treatable stage.

That depends on the cancer. Breast cancers grow at different speeds. Some grow slowly over years. Others grow fast. A delay of a few months may matter a great deal for one woman and very little for another.

Medical malpractice lawyers and their experts in oncology look at a few things. They compare the tumor size when the lump was first reported to its size at diagnosis. They check whether the cancer had reached the lymph nodes, the small glands under the arm that filter fluid, or other organs. They look at the type of cancer and how fast that type tends to grow. And they measure the time between the missed chance and the diagnosis.

A delay can also change treatment. A woman who might have needed a small surgery may have needed a mastectomy, which removes the whole breast. Or she may have needed chemotherapy, strong cancer drugs, that might have been avoided.

In Pennsylvania, a family does not always have to prove that an earlier diagnosis would have saved her. It can be enough to show that the delay meaningfully raised the risk of harm. That added risk must also have played a real part in what happened.

When is a missed breast lump not medical malpractice?

Not every delay is malpractice. A bad outcome does not prove someone made a mistake.

• The right workup was done. You had a diagnostic mammogram and an ultrasound, and both were read correctly. Some cancers do not show on a mammogram or ultrasound, even when the test is done and read well. A doctor who did the right workup is not at fault just because the cancer was found later.
• The lump was checked and was harmless. An ultrasound showed a simple cyst. The cancer was found later in a different spot.
• There was no lump at the time of the normal mammogram. A cancer that appears between yearly screenings is often no one’s fault. Our article on cancer found less than a year after a normal mammogram covers this.
• The delay likely made no difference. The cancer may have already spread when the lump was first reported. Or the stage would likely have been the same months earlier.

What harms matter in these cases?

Our firm focuses on delays that led to death or catastrophic injury. In breast cancer cases, these are the harms that usually matter:

1. Cancer that spread to distant organs, such as the bones, liver, lungs, or brain, before it was found. It can still be treated, but it can no longer be cured.
2. Death from a breast cancer that, if found earlier, would likely have been curable.

What to Expect when you contact our office

Before we take a case, we review the records and imaging with medical experts. Pennsylvania requires a medical professional’s written statement that a claim has merit before a case can go forward. That review also helps answer whether the delay changed the outcome. A doctor, a nurse practitioner, a practice group, or an imaging center may each have played a role.

Pennsylvania has filing deadlines. For a living patient, the deadline is generally two years from a key date. That is when she knew, or should have known, that she was harmed and that medical care may have caused it. In delayed diagnosis cases, that date is often at or near the cancer diagnosis. After a death, claims generally must be filed within two years of the date of death. Our page on how long you have to file in Pennsylvania explains more. For background, see our main breast cancer page.