Cancer missed in 14 women at East Lancs Hospitals Trust (From Lancashire Telegraph)

Cancer missed in 14 women at East Lancs Hospitals Trust

9:30am Thursday 17th September 2009 in

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FOURTEEN women have been told they have breast cancer after a consultant failed to spot their illness.

A radiologist is being investigated after 355 mammograms had to be re-checked when colleagues raised concerns at the East Lancashire Hospitals NHS Trust.

Eighty-five women had to undergo a second breast examination, and 14 were told they had invasive breast cancer.

Health chiefs said it was not known whether the delay would harm their chances of recovery.

Another four women were diagnosed with a secondary breast condition, but medics insist their prognosis will not be affected by the wait.

Hospital bosses are stressing that if patients have not been contacted by the trust so far, their results are not being called into question.

They have also issued a public apology and stressed that no further cases are likely to be identified.

But critics said they were were “horrified” by the revelations and demanded reassurances that such mistakes will not be repeated.

The radiologist in question is not at present working for the trust and is under investigation. However, the hospital trust has declined to say whether the unnamed medic has been suspended.

He is believed to have considerable experience and had worked for the trust for a number of years.

The radiologist was working at Accrington Victoria Hospital, where screening is undertaken for the whole of East Lancashire.

Some of those affected are from Blackburn and Darwen but the majority live in Burnley, Hyndburn, Pendle, Rossendale and the Ribble Valley.

The announcement is the latest blow for the under-fire trust, in the wake of concerns over East Lancashire’s accident and emergency provisions, recent superbug outbreaks and two short-lived chief executives.

Rineke Schram, the NHS trust’s medical director, said: “On behalf of the trust, I would like to apologise for any distress and anxiety this has caused.

“The delay in identifying the women with breast cancer does mean that there has been a delay in these cancers being treated.

“It is unfortunately not possible to state with certainty whether this delay in treatment has affected the prognosis other than to state that early-stage breast cancers have a good prognosis.

“The cancers have been picked up through the screening system, albeit with a delay.”

Regional breast cancer experts were drafted in after the initial concerns were highlighted last year.

Their independent review centred on a single radiologist and cases where women had been recalled after potential abnormalities had been identified by initial screening mammograms.

Colleagues became concerned that some of the consultant’s assessments were incomplete so further checks were made.

All screening assessments carried out by the radiologist for the past three years, totalling 355 cases, were rechecked.

Eighty-five women were asked to attend special clinics, where their cases were reviewed by senior consultants.

Eighteen cases - 14 invasive cancer and four for ductal carcinoma in situ (DCIS) - were discovered as a result.

Now the 14 are undergoing further treatment. The four with DCIS had abnormal cells present in milk ducts but these had not spread to other breast tissue.

Health chiefs have not revealed how long the delays were for these patients between initial check and eventual diagnosis.

The consultant has not conducted breast screenings since last December and not worked at the trust since April.

Mrs Schram said: “The work of the trust’s other breast screening radiologists has been independently assessed and found to be of a high standard, establishing that the issue related solely to the individual radiologist concerned.

“The trust will be commissioning a further independent review to provide further assurance and ensure lessons are learned for all NHS organisations.”

The review will be carried out with the support of local primary care trusts, the regional breast screening quality assurance programme and NHS North West.

Mrs Schram said: “The women involved are being kept fully informed of the situation. Any women who may be concerned should not hesitate to contact our helpline for further advice.

“I would like to reassure all women who visit East Lancashire Hospitals for initial mammograms that our concerns relate only to the secondary tests following screening by one individual doctor.”

Dr Ellis Friedman, NHS East Lancashire public health director and regional breast screening quality assurance programme director, said: “The NHS breast screening programme is committed to the achievement of the highest standards of performance.

“It is always a concern when one of its programmes fails to achieve these standards for all women.

“In this incident in East Lancashire, 18 women have had their cancer diagnosed later than should have been the case.

“The incident team, which I chaired, has thoroughly reviewed the incident and will ensure that lessons will be learned.

“The public will wish to know if the service is safe, and I can confirm that the East Lancashire programme is meeting all the important quality and outcome standards set by the national programme.”

The helpline for women worried about breast screening is 01254 732093 and will be open daily from 7am to 10pm. An e-mail address - screening.helpline@elht.nhs.uk - has also been set up to deal with concerns.

MPs and health campaigners said they were “horrified” at the breast cancer screening blunders.

Hyndburn MP Greg Pope said: “I was horrified to hear this news and we must ensure that it never happens again by getting detailed answers.

“The trust now needs to reassure me and the public I represent that failures in the screening process have been addressed.

“My first thoughts are with the women who have been affected and the huge distress it must have caused their families. They now deserve world class treatment.”

Emma Pennery, clinical director at national charity Breast Cancer Care, said: “This news that 18 women have experienced a delay in diagnosis will undoubtedly cause anxiety among those that have undergone breast cancer screening at this hospital.

“While women should be reassured that a full review has been conducted it is understandable that individuals may have ongoing concerns, and we would urge them to contact the hospital’s special helpline.

“Additionally our own free helpline, on 0808 800 6000, is available to anyone with questions about the breast screening process and breast cancer in the light of the announcement.

“Despite the specific problems that this case has highlighted, it is important to stress that breast screening still remains one of the most effective ways of detecting breast cancer as soon as possible, and we would urge women to continue to attend their screening appointments.”

Former hospital governor and Burnley councillor Darren Reynolds said his thoughts were with the women affected.

He said: “To have been called in over their test results, then given the all clear only to be told they do have breast cancer after all is devastating.

“The toll this will have had on them and on their loved ones is something you can only imagine.

“It’s important to know what has caused this problem and ensure it never happens again”

Burnley Council leader Gordon Birtwistle, who has fought a campaign to return an A&E to Burnley, said the blunders showed ‘series failures with proceedures’.

He said: “It is a very very worrying situation all round.

“There is no point saying these mistakes were caught at a later date, because the critical time period for diagnosing cancer is in the early stages and giving someone the all clear is bound to cause a serious delay.

“I would like answers as to why this radiologist’s work wasn’t checked routinely at that key point in time.

“When I was an engineer making airplane parts, my work was checked there and then. You would think the same thing would apply here.”

Burnley MP Kitty Usher said she was deeply concerned, but was glad the problems had now been uncovered.

She said: “It must be understandably very upsetting for all concerned.

“I am at least glad that the trust is now aware of the situation and hope that the best possible care is now offered to these women.”