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Janet St. James
Misdiagnosis fears deter breast exams
12:10 PM CDT on Tuesday, October 23, 2007
Focusing attention on lifesaving ways to stop the second leading cancer killer of women, October is breast cancer awareness month.
Thousands of women are leery of screening, afraid they may be misdiagnosed, which was exactly what happened to Darrie Eason.
The 35-year old single mother had a double mastectomy. A mammogram incorrectly showed a suspicious mass. Then, the lab results were misread to show she had cancer.
"They told me, 'You didn't have cancer and you never did,'" Eason said.
Mammography is between 55 to 85 percent accurate, according to studies.
"That's a broad range," said Dr. Katherine Hall, a radiologist at the Presbyterian Hospital of Dallas. "The reason is in younger women who have denser breasts. It is kind of difficult sometimes to see cancers because of the breast density."
Dr. Hall said fear of false positives and missed cancers sometimes discourages women from getting screened.
"You have to create technologies that anticipate that humans will blow it from time to time and catch the errors before they kill someone," said Dr. Robert Wachter, a patient safety expert and author.
Among the newer technologies to make breast cancer diagnoses better is the breast MRI.
"MRI is much more sensitive in detecting cancers," Dr. Hall said, though she admits there are still major drawbacks with the MRI.
Insurance companies often refuse to pay the $1,500 cost. Since the machine itself is so expensive, breast MRIs are not available in most clinics, while mammograms are.
Presbyterian Hospital of Dallas has a breast MRI machine, but they can't use it for screening, even for patients who offer to pay.
Dr. Hall said the combination of scans, MRI, sonogram, and mammogram together, have a 95 percent success rate. That is as good as other screening rates.
For Vanita White, it took all three to find her cancer.
"I think they really do work," she said. "It may not be what you want to hear. There may be false positives, but it's always better to be safe than sorry."
Still recovering from chemotherapy and breast reconstruction, White is looking forward to a better year with her daughter and husband and on the job as a Dallas county prosecutor.
Eason said she will end her year with a lawsuit, knowing she never had cancer in the first place.
"I have a philosophy that you have to laugh to keep from crying," she said. "So, I try to laugh as much as I can."
E-mail jstjames@wfaa.com
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