When Elena Ivanova found a lump on her right breast after a skiing accident in early 2016, she wasn’t overly concerned. Years earlier, after nursing her two daughters, she had noticed a similar mass but it turned out to be nothing.
However, Ivanova wanted to be sure, so she went to see her GP. A mammogram and biopsy followed, before a shocking appointment with a surgeon who told Ivanova that she had a rare and aggressive cancer known as metaplastic carcinoma.
“I couldn’t believe it. Time stood still for me,” said the 61-year-old groomer from North Vancouver, BC.
Just nine days later, on March 24, 2016, Ivanova underwent a full mastectomy and prepared for the harsh chemotherapy and radiation treatments that would follow.
But when it came time for her first appointment with an oncologist at BC Cancer to discuss a treatment plan, Ivanova was hit with another bombshell.
“The doctor said, ‘I have good news. You don’t have cancer,'” he recalled in an interview with Breaking:.
“It is difficult to describe what I felt. Why did I have this surgery?… I know it’s good news, but it was very, very, very hard, because it’s a human body. If you damage it, you cannot restore it.”
In May, more than seven years after Ivanova had her breast removed, a British Columbia Supreme Court civil jury awarded her $400,000 in damages from Dr. Robert Wolber, the pathologist who mistakenly diagnosed her with cancer.
But Wolber is appealing that verdict, which means most of the jury prize has been withheld, and it will be months before Ivanova has a resolution.
The wait has been frustrating.
“I really wanted to find the truth,” Ivanova said. “People must be protected. Mistakes like this must not be made, and if they are made, they must be corrected.”
Biopsy report ‘unclear and contradictory’
Wolber has not responded to requests for comment. His response to Ivanova’s claim denied any negligence and held that “all medical procedures and investigations conducted by him with respect to the claimant were appropriate in the circumstances and in accordance with standard medical practice.”
The response notes that while Wolber’s biopsy report diagnosed Ivanova with metaplastic carcinoma, his recommendation was an excisional biopsy to remove the lump so it could be examined more closely, not a mastectomy.
But Dr. Ashley Cimino-Mathews, a pathologist at Johns Hopkins University in the US who specializes in breast tumors, wrote in an expert witness report that an excisional biopsy would not be the appropriate response to such an aggressive cancer.
His report says that Wolber’s decision to “unequivocally” diagnose metaplastic breast carcinoma fell “below the standard of care,” and he should have communicated any doubts about the diagnosis in his biopsy report.
Finding Wolber negligent, the jury described Wolber’s pathology report as “confusing” in light of the seriousness of the diagnosis.
“He diagnosed one disease and recommended treatment for another. This was unclear, inconsistent, and below the standard of care for a reasonably prudent pathologist,” the jury wrote.
Ivanova’s attorney, Don Renaud, said Wolber is exercising the same right to appeal that all Canadians enjoy, but that the judicial appeal process will only add to the cost of an already expensive legal fight.
He argues that it is only possible for doctors to spend so much money defending themselves against allegations of negligence thanks to the deep pockets of the Canadian Medical Protection Association (CMPA).
The CMPA is a mutual defense organization that defends doctors accused of wrongdoing using assets valued at more than $6 billion. It is financed by the annual fees paid by doctors, most of which are reimbursed with public money through agreements with the provinces and territories.
“What really should have happened here is that, with proper public understanding of what happened, then those practices that led to this tragedy can be improved,” Renaud said.
A CMPA spokesperson told the CBC that the organization could not comment on individual doctors and that it would be inappropriate to say anything about a matter that is still before the courts.
‘I threw away all my beautiful dresses’
Ivanova says the mastectomy has caused lasting damage to her physical and mental health.
“I was always in good physical condition, but after the surgery I started having nightmares. I couldn’t sleep well,” he said.
“I don’t feel like I’m an attractive woman anymore. I have to hide my damage. I threw away all my beautiful dresses.”
She says she loves to hike, but continued weakness means she can no longer handle the same intensity on her mountain hikes. Yoga leaves her with back pain she’s never had before.
“It’s hard to accept,” he said of his new reality.
Ivanova’s lawsuit also accused the surgeon who performed her surgery of negligence, but the jury found that she did not violate the standard of care.
Today, Ivanova believes that anyone faced with a frightening diagnosis and drastic treatment recommendations should not be afraid to ask their doctors for more information.
“They’re good, they’re highly educated, but they have to give you more time, more attention. If you get an opinion, get a second opinion, a third opinion,” he said.
“Ask them to explain it to you 10,000 times. It is their job to explain it to you correctly. We are not doctors.”
