Robin Gray, R.N.

Robin’s Story- Misdiagnosis

In November 2000 38-year-old Robin Gray RN, native of Baltimore, MD and current resident of Upstate New York, was smooth sailing through life and enjoying her brand new dream home with her husband and her three young boys, ages 2, 7 and 9 years of age. Then out of the blue one day, just prior to Thanksgiving, she took a bath and was shocked to find a tiny pea sized breast lump and was immediately terrified, especially since she knew her grandmother had died of breast cancer.
Like many women Robin turned to experienced physicians for consultation, assessment, and guidance. She was especially confident in her doctors, as her husband, a medical doctor in a small Upstate NY town, had recommended them. A mammogram, breast ultrasound, and clinical breast exams were done by a radiologist and Robin was told that her lump was only a cyst and she only needed to see a surgeon for long term-monitoring. When she saw the breast surgeon, she received another breast ultrasound and clinical exam and was told the lump was benign fibrocystic breast condition, nothing to worry about, and that a lot of young women have breast lumps. She was also scheduled for follow-up in three weeks, and when that appointment arrived, she was again reassured that her lump was benign. When the cyst started to enlarge, three months later, Robin saw her breast surgeon again, and he said that breast cysts could harmlessly increase in size in pre-menopausal women like her. Then he did a fine needle breast biopsy for the lump enlargement, aspirated fluid, and assured Robin her lump was only a cyst. A pathologist also rendered an opinion on the fine needle aspiration biopsy, declaring it was benign. About six months later, Robin returned to the same breast surgeon, informing him that the lump seemed larger and that she was worried, especially since her other grandmother just died of breast cancer. The surgeon did another breast ultrasound and assured Robin once again that lump was benign and that second degree relatives, like grandmothers, would not increase one’s risk for breast cancer.

A long six month later and seventeen months after Robin had first seen her doctors for a breast lump, she returned to her breast surgeon once again, as the lump was very large and uncomfortable, and she received a repeat fine needle aspirate biopsy, alarmingly learning that she had breast cancer. Finally, her surgeon removed her lump, which increased in original size from a small quarter inch lump to about 7 cm in diameter. Due to the large size, it required ultimately a mastectomy, nodal dissection, and an additional excisional surgery to clear the extending margins of the untreated cancer. Furthermore, she required chemotherapy, as cancer was found to have spread to her lymph node. She also required Herceptin for her aggressive cancer subtype, often found in young women.

Despite the fact that Robin had doctors with years of medical experience assess her breast lump, she was ultimately delayed diagnosed with breast cancer for almost a year and a half, resulting in many more treatments with a worse prognosis. Nothing in her years of training as a nurse prepared her to be able to avoid a breast cancer misdiagnosis. Nor was her husband, a medical internist physician, able to guide her from avoiding a misdiagnosis, as he literally could not see the mistakes that his physician colleagues were making.

After Robin’s misdiagnosis and following months of more aggressive surgery and medical treatments required as a result of the delayed diagnosis, she was finally able to catch her breath to investigate the mystery behind her misdiagnosis. She had several physicians give second opinions, third, and even fourth opinions on her mammogram, breast ultrasounds, and breast biopsy. Through these opinions, she ultimately discovered that there were multiple errors in her breast diagnostic testing and that her surgeon over-relied upon a needle aspirate biopsy rather than doing a more definitive core or excisional biopsy. She did eventually file a medical malpractice lawsuit and settled out of court, and she filed a complaint with the Office of Professional Conduct in her state against her negligent radiologist, surgeon, and pathologist who misdiagnosed her.
Robin’s story is not uncommon. At least ten thousand women per year are misdiagnosed with breast cancer and most of these women are young! (1) Physicians commonly misdiagnose young women due to age bias where breast cancer is not expected in a young woman, as the median age for a breast cancer diagnosis is 63 years old. (2) As a result, often physicians do not do all the correct tests and aggressive procedures to adequately rule out cancer, thinking cancer is not possible in a young women. (3, 4) This is particularly unfortunate as young age is a negative prognostic factor in breast cancer diagnosis, where cancer is often more aggressive, and a delayed diagnosis may gravely impact on prognosis. (5)
Today, Robin is a seven year survivor.  She is just happy to be alive and tries to live one day at a time to its fullest, while moving forward and putting her misdiagnosis behind her. She feels miraculously blessed to be here enjoying her family of three boys and a loving husband.
She also feels a calling to turn her tragic experiences into something positive for others and educates other women that it is not enough to just see a doctor when a breast lump is found. Instead, Robin suggests that women need to become their own advocates. She recently published a book about her experiences, called BREAST LUMP WHAT LIES BENEATH, in order to help increase awareness of breast cancer in young women, to increase awareness of the epidemic of doctor-related breast cancer misdiagnosis in young women, and to help guide women in how to obtain the correct breast diagnosis. Robin also believes her story will encourage those who have already suffered a misdiagnosis or cancer diagnosis. You may visit her new educational website, with life-saving information about breast lumps and emotional healing information for a misdiagnosis or cancer diagnosis. A percentage of the proceeds from her book will go to the Young Survival Coalition.

If you would like to help, share your Survivorship story, or your Co-survivor story and make a difference! Contact stacy@fightpink.org.

Bibliography

(1)(3)-Goodson, William H. III, MD, Moore, Dan H. II, MD. “Causes of physician delay in the diagnosis of breast cancer.” Arch Intern Med. 2002: 1343-1348.

(2)(4) (5)-Kern, Kenneth A., MD. “The delayed diagnosis of symptomatic breast cancer.” In:  Bland K.I., Copeland E.M. III, eds. The Breast:  Comprehensive Management of Benign and Malignant Disease. 2^nd ed. Philadelphia, Pa:  WB Saunders Co.; 2004: 1588-1628.