Oncology expert witness advises on relapse of breast cancer despite treatment

A breast oncology expert witness advises on relapse and spread of woman’s breast cancer despite treatment. The plaintiff was diagnosed with right breast cancer in 2006 and underwent surgery in 2008. The tumor was 1.5cm by 1.3cm by 1.0 cm, and the cancer had spread to two lymph nodes in her armpit and was spreading into the surrounding tissues.

The defendant treated the plaintiff with radiation in the summer of 2009. Eight months later, the plaintiff complained of weakness and numbness in her arm and hand. A small area of suspicious activity was found in the same area where the cancer previously had been seen to be spreading. A new, larger tumor was located and surgically removed, and the plaintiff underwent additional chemotherapy using Taxotere as well as radiation.

The cancer then spread to the plaintiff’s liver, brain and spine and she died in 2012; no mitigating procedures such as stereotactic brain surgery were performed.

The complaint, originally filed by the patient and then pursued by her husband, alleges that although the doctor performed radiation therapy, the doctor failed to design, target and treat the appropriate targeted areas.

Question(s) For Expert Witness

1. Did the defendant breach the standard of care for radiology oncologists?

2. What was the result?

Expert Witness Response

I have found significant flaws in the radiation plan, and in the radiation treatment given to the plaintiff. The radiation plan shows an area approximately 1.5cm in width that was not treated at all with radiation. This area of non treatment is exactly where the surgeon had purposely left the axillary clips, because he was worried about any residual tumor being left behind. The net result of these errors in radiation therapy design was essentially that no treatment was given to the area most likely to have residual cancer.

As a direct consequence of faulty radiation therapy treatment design, the patient's cancer came back. This failure to treat the area outlined by the surgeon with the placement of clips was a negligent act or omission that was the proximate cause of the recurrence of the cancer and the ultimate death of the patient.

It is my opinion to a reasonable degree of medical probability that the care rendered by the defendant fell below all applicable standards of care in the field of radiation oncology.

The expert is board certified in radiation oncology and has extensive inpatient and outpatient radiation oncology experience.