[The female breast as an object of liability complaints. Analysis of relative jurisprudence]

The authors analyse the incidence of medico-legal actions that can follow surgical and irradiation treatment of tumours in the female breast under French jurisprudence, which is now well established. Also involved are cosmetic surgery and all reconstructive procedures on the breast. Attention is drawn to errors that should be avoided in order to minimise the risks of being sued. There has been according to the files that have been inspected, a drop in legal actions for surgery of the breast for growths because radical surgery has become less frequent and less extensive. On the other hand there have been more complications from irradiation or from chemotherapy that has not been well controlled and where the risks had not been properly explained to the patients before treatment started. The article brings to attention how important it is to obtain informed consent about all details including very rare complications, particularly when the indication for the operation is cosmetic or for comfort and not in order to cure disease. Finally, the authors discuss the problem of cancer eventually developing in a tumour of the breast which appears after trauma received by the breast from seat-belt compression injuries. In spite of the unclear pathological causes so far discovered, there may be cause and effect between traumatism and a tumour discovered after an interval. It is suggested that immediately after the injury a careful examination of both breasts should be undertaken using mammography and ultrasound, including the anterior wall of the thorax, so that early diagnosis is made of possible signs suggesting that a tumour would be likely to develop. This should be done in spite of the presence of a haematoma in or around the breast.