A breast cancer patient asked Dr. Robert Whitfield to leave her implant capsule partially intact during surgery, against his standard practice. Pathology found no cancer recurrence, but revealed a hidden E. coli infection with 10 million bacteria, likely from a hospital stay. The case made him reconsider when to follow patient requests over evidence-based protocol.
There was a cancer patient in 2016 that really changed all this. So she's the one who showed up and said, hey, can you do an in-block cap selective? And I was like, why? I know cancer, that's my whole career. And I'm like, why would a patient even use that term? Such a weird ask. So I'm like, yeah, I can do that, but that's really a cancer case for somebody who has a cancer around the device. And you've already had breast cancer, that, that doesn't make a lot of sense. And I was like, I do— I always do these the same. I take everything out. I always did a complete capsulectomy. She was just asking to do an intact capsulectomy, which was, you know, we can talk about why that's feasible. You send off all the capsule material after you swab it, make sure there's, you know, it's checked for bacteria, fungus, mycobacterium, and then you send everything off to make sure there's no recurrent cancer. That's just what I was trained to do, and that's what I do every single time. So her, her, uh, you know, it takes like a week to get everything back. Comes to the clinic and, um, her pathology is negative, which is great. She has no recurrence, the scar is negative, all the stuff's fine. And then it comes back, she has an occult E. coli infection, and not just a little bit, right? She has 10 to the 6 in a hospital, uh, setting. Because I did her case at a hospital, uh, because she had a cardiac, uh, need to be monitored overnight. So I went back through all the notes and I was like, what
