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Science & Technology

Swedish woman loses breast after misdiagnosis

Published: 4 Nov 11 14:00 CET | Print version
Online: http://www.thelocal.se/37164/20111104/

A 32-year-old woman in Gävle in eastern Sweden had her breast removed following a faulty diagnosis, even though her mammogram showed no signs of a tumor.

The woman had at first received the news she’d hoped for following an initial mammogram: there was no tumor, the local Arbetarbladet newspaper reported.

But subsequent tissue samples gave a different answer.

According to that test, the 32-year-old was suffering from breast cancer, and the decision was taken to remove her breast.

After the operation, however, no tumor could be found.

The woman's unwarranted breast removal is the second such case to take place at the hospital in Gävle in recent months.

The Local reported in July about a 47-year-old woman who had her breast removed after a contaminated test led doctors to believe she had cancer.

Another woman, 34, had her breast removed by mistake following a misdiagnosis.

Johan Ahlgren of the hospital's oncology department said at the time that the mistakes were the result of a dearth of pathologists at the hospital.

“We’ve had a few too few pathologists during the past year, which has led to some mistakes. How many that could be I can’t really say,” he told the local Gefle Dagblad newspaper in July.

The case of the 32-year-old has been reported to the National Board of Health and Welfare (Socialstyrelsen), and chief of medicine at the diagnostics department in the Gävleborg County Council, Bengt Larsson, expressed his regret about the incident.

“This is very unfortunate, it is not acceptable that things like this happen,” he told local newspaper Arbetarbladet.

“The stressful environment and the pressure to handle many tests may have affected what happened.”

TT/Joel Linde (news@thelocal.se)

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14:51 November 4, 2011 by Opinionfool
There has been a debate over in England recently on whether mammograms are actually a good diagnostic tool. They have apparently cause more unnecessary massectomies than lives saved, or so the consultant who first argued *for* general mammogram screening now argues.
14:55 November 4, 2011 by Lavaux
New Socialstyrelsen policy: Don't check the removed breasts for tumors.
15:01 November 4, 2011 by Online Personality
Swedish politicians serially underfund health care and use the "savings" to fund their own agendas. Sweden cannot support the people its politicians continue to import. How can this not be interpreted as the state systematically killing one group of people (sick / elderly) in order to clothe, feed, house, educate, etc another group of people (those it purposely imports)? This is an outrageous abuse of human rights, and everyone loses.

I'm so sorry for these women and hope they at least have loving, supporting family and friends. DO NOT TRUST the Swedish medical system! If you are in anyway financially able, leave the country and get a second opinion! It's not right that a person should have to do this, but it will be the person and his/her family who alone suffers a lifetime of painful consequences and pays the price. The socialstyrelsen and politicians could care less...
15:08 November 4, 2011 by krrodman
Speaking as a physician, none of this makes any sense.

If she had a normal mammogram, why did she have the biopsy to begin with? Did she have a breast mass with a normal mammogram?

What does a "dearth" of pathologists have to do with misdiagnosis?? If there are too few pathologists, then there may be a wait until the tissue samples are read, but it should not impact on the correctness of the diagnosis once made. (unless it is a "dearth" of quality pathologists.)

My understanding is that Sweden, more than any other country, does what is called a "skinny needle biopsy" which is a minimally invasive sampling of tissue. My understanding is that with such a small sampling of cells it is more difficult to make the correct diagnosis. Perhaps that was the problem here.

The debate over mammography is complex. The issue is not whether mammography aids in the diagnosis of breast cancer. It certainly does. The question is whether or not frequent mammography saves lives. Or put differently, if a woman has an aggressive breast cancer, she is destined to die no matter how early it is caught. So, early diagnosis because of frequent mammography will not change the inevitable death of this patient. Alternatively, a slow growing, nonaggressive tumor does not need to be caught early in order to save the life of the patient. Once again, frequent mammography will not change the outcome.
15:11 November 4, 2011 by conboy
Very upsetting for the woman in question I hope she sues the county council Admin. and recieves support and counselling at the expense of the offending authoritiies.
15:21 November 4, 2011 by Svensksmith
Always, always, always get a second opinion. In Sweden, you might even want to get a third or fourth.
16:04 November 4, 2011 by cattie
A second or third opinion is of some help, although you are still at the mercy of the system. "Caregivers" operate in a system with limited consequences for medical mistakes.

If there is a an error, you will get an explanation beginning with "Tyvärr..." or "Unfortunately..." as if bad luck had something to do with it.
16:36 November 4, 2011 by krrodman
@Cattie

No one is denying the tragedy here. The problem is that we have no idea what the problem is.

For example: You recommend a 2nd opinion. Let's say, hypothetically, the pathologist miss labels the names on two sets of slides. If that were to happen to Jane Smith, a patient with breast cancer, she would be told that she is cancer free, while the other patient, Mary Jones, who really has no breast cancer, will be mistakenly told that she has cancer. If Mary Jones took "her" slides to a another doctor for a second opinion, the other doctor would concur that Mary Jones has cancer. In this case a second opinion would not have changed the outcome.

Without knowing exactly how the system failed this patient, it is impossible to create new policies to prevent it from happening again.
16:44 November 4, 2011 by GeoC
A second opinion involves a second full work up. Not a second opinion of the first opinion, a second opinion overall.
16:48 November 4, 2011 by Mb 65
Stress there is only 9 million people in Sweden, what would they be like with 62 million to deal with as there are in the UK. i would get an opinion outside of Sweden.
17:14 November 4, 2011 by Opinionfool
@Mb 65

But whatever you do don't go to the US for that second opinion. There you'll pay for it with an arm and a leg quite literally, oh and your spare kidney for transplantation.
19:25 November 4, 2011 by hackie
@Opinionfool #11,

Hehehe. You made my day :P
19:46 November 4, 2011 by krrodman
@genc

Really. A second biopsy for every woman. Of course, that would have to be for both positive and negative biopsies, right? Can't trust any results, right?

And, what if there is a conflict between the first two biopsies? Do you do a third biopsy to break the tie?

And, the million Kroner question, who is going to pay for all of the repeat biopsies?
21:38 November 4, 2011 by dizzymoe33
Yes there really needs to be a new system implemented to require biopsy results to be double checked. Especially when the recommendation is for surgery. This is such a traumatic event to happen to these women out there. It is not like you can go out a replace your breast(s) with another one naturally. The damage to their bodies and the emotional traumas is too much to put people through when a simple 2nd opinion or a doubled checked biopsy could have been performed first. Such a sad thing to happen to anyone.
23:46 November 4, 2011 by CLiv
@Online Personality - Not sure were you are from, but I do trust the Swedish Medical system. That doesn't mean you don't question things, you should always do. There are mistakes happening in any country and their medical systems. I was misdiagnosed in the USA, and couldn't leave my house for months. I was a healthy 20 year old who worked out every day, and suddenly could do nothing. I pay outrages amounts for health care in the USA and lord and be hold they freaking misdiagnose you. Oh, and on top of that in Florida there was just a 17 year old masquerading as a physician assistant at a hospital. That gives me such faith in the USA health system that we pay an arm and a leg for.
01:42 November 5, 2011 by Boeing_787
May I use this opportunity to ask an aside question. I have Swedish citizenship but have been living the U.S., and my Personbevis does indicate that I'm registered as living abroad; when I return to Sweden for vacation and if i seek medical care, will it be free (or at same cost) to me as it is to Swedish citizens (that live in Sweden).
04:34 November 5, 2011 by swenrika
Oh boy... It is soo sorry to hear... those poor women, hope they are doing fine and get all the love and care they need..
05:39 November 5, 2011 by Grokh
another one ? thats like the 4th i hear this year....
08:28 November 5, 2011 by Lavaux
Boeing 787,

When you're in Sweden on vacation, you can go to an ER for the ailments treatable there. However, you can't get treated at a clinic (vårdcentralen) until you go to Skatteverket and register yourself as a resident of Sweden.

Regarding the quality of medical care and your likelihood of recovering adequate compensation in the event of medical malpractice, your chances in the U.S. are much better than they are in Sweden. The subject of this article will recover very little for her injuries, and the culpable doctor will get at most a slap on the wrist. Her case against the doctor will be an administrative one, probably heard on the documents, with no chance to explain to a jury of her peers the nature and extent of the harm done to her. She'll be awarded a negligible sum of money ($30 - $50 K) and then be swept under the rug to join the growing number of socialized medicine's victims. This will happen so that Swedes can continue to believe that their health care system is the best in the world.

So my advice to you is to get all the health care you need in the U.S. before ObamaCare kicks in. Once that happens, it'll be a wash.
11:04 November 5, 2011 by Online Personality
´@Clive - Kiss my ass, you arrogant prick. I am sorry for your pain and ill treatment, and I believe the medical profession as a whole can do better to be more humane and compassionate. However, your storry is an absolute joke compared to the hell I have been through. And a joke compared to the story at hand and others within a similar realm.

If you are a thoughtful person, you will do the research yourself regarding the pros and cons of US private care vs other state care. Raving US idiots forget that not all state care is the same quality. Neither system is perfect and thoughtful people look to build a system based on the pros of both systems (private/public) while deminishing the cons.

I suggest you get a good whiff of the suffering of many in Sweden before you arrogantly preach at us. To use the phrase of another poster, Do you think for yourself or do you just believe what your handlers tell you?

There is nothing that I have said that has not been said (in varying degrees) by Swedish people posting in Swedish. Doctors and nurses who care are more aware of the problems than I'm sure I can imagine. There are support/activist groups for a variety of illnesses, all campaigning for better treatment and care.

Furthermore, throughout socialized systems funded by heavy taxes, a good many people also buy private insurance because the state systems often fail. Trust the system all you want, it's your life on the line. But for others who want to survive, I strongly advocate second opinions outside of Sweden. This is not a random political agenda. This is the desire to save other people. Just like other people (Swedes!) helped save my life by helping me get care outside of Sweden.

But why bother with even writing this... people like you believe what makes them feel most comfortable. If anyone points out evidence for an alternate version of reality, you're put down bc you've poked a little whole in someone's comfort bubble...
21:56 November 5, 2011 by Investor612
Lots of room for improvement in the US system, especially for the bottom 20%. But being familiar with the quality and speed of healthcare our Swedish family members have received and our own, we wouldn't trade.

Not looking forward to a national healthcare system. Maybe individual states could address it more efficiently.
00:50 November 7, 2011 by Boeing_787
Hi Lavaux,

Thanks for the reply. Just to be clear, my costs, if any, for the ER treatment would be the same as for a normal swede in sweden then?
14:22 November 8, 2011 by yourkidding
Pretty glad they don't do too many "testesectomies" or a whole lot of us guys would be walking around talking like Michael Jackson uneccesarily.
18:26 November 9, 2011 by SockRayBlue
Some doctors in the US are a bit too free with their diagnosis of breast cancer. Where the removal of a cyst will suffice they go for the entire mammary. Overkill and quite unnecessary. The support for breast cancer far overwhelms that of prostate, testicular and rectal cancer. I guess the pretty pink ribbon sells better than a brown one.
15:37 November 14, 2011 by R5S
Boeing_787

Swedes redient abroad:

I was told that acute care is covered like for residents (same low cost) but ailments that did not start while in Sweden are not covered, meaning you pay full cost (same set price as they bill counties when patient lives in another swedish county); very expensive. Next time you are there, just walk in and ask.
21:36 November 14, 2011 by Boeing_787
Hi R5S,

That's good to know. I will try to find out more when I visit next time, which should be soon. I would like to think that since I'm a swedish citizen, if i really did have an ailment and hypothetically had no access to treatment from abroad, that i could somehow return to sweden and get treated, even if it means i have to meet some minimum criteria of residing in sweden.
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