Delay in the clinical diagnosis of breast cancer: estimating its effect on prognosis, with particular reference to medical litigation.

Medical malpractice litigation is increasing. Delay in diagnosis is the commonest basis for litigation involving the treatment of breast cancer. When delay in diagnosis has occurred, any losses for which a plaintiff seeks compensation require estimates to be made of any change in prognosis over the period of the delay relative to the extent of disease found when treatment is finally undertaken. We have examined the natural history of breast cancer and have attempted to provide evidence-based quantitative guidelines for the evaluation of the losses which may be claimed in malpractice cases.