Twice the trouble for not conducting triple test

A woman, approaching fifty years of age, visited a diagnostic centre for routine check-up. The report changed her life permanently.

A small lump in her left breast was noticed. It was sent to another diagnostic centre for fine needle aspiration cytology (FNAC) test, which reported ‘no evidence of malignancy’. The patient breathed a sigh of relief.

After about a year and half, the lump had grown in size. The patient visited yet another diagnostic centre where it was confirmed that it was cancerous.

The patient underwent mastectomy – her left breast and adjoining tissues were removed. She also underwent sixteen chemotherapy sessions.

She was obviously devastated and blamed the first diagnostic centre for her ordeal and unfortunate series of events. It was alleged that the wrong FNAC report was the root cause of everything that went wrong.

The diagnostic centre rejected patient’s claim and stated that second FNAC was done after a year and half and it was possible that benign tumour transformed to a malignant one by then.

It was further stated that triple test is necessary to confirm diagnosis of breast cancer. FNAC was only one part of the triple test; other two being history and clinical findings of breast examination, and imaging and mammography and / or ultrasound.

Sensitivity of triple test is greater than any of the individual component to rule out malignancy. Thus, FNAC test report cannot be viewed in isolation, concluded the diagnostic centre.

The Commission accepted this defence, and also cited medical literature in favour of the diagnostic centre.

The Commission observed that patient took opinions from three different diagnostic centres. Neither reported malignancy. It was further observed that the doctor whom patient consulted should have referred her to a surgeon for further advice or treatment rather than relying on FNAC report.

Patient’s complain and case against diagnostic centre was dismissed.