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The battle against breast Cancer is, to many women one of the most important in medicine today. We must not forget however that men can also suffer from the disease, although thankfully the number contracting the disease each year is small.
Fortunately there has been a 24% fall in mortality rates since 1989 and the levels of survival are improving greatly.
There are approximately 44,000 cases of breast cancer diagnosed each year. The majority will occur in women who have gone through the menopause and this is therefore the sector the NHS concentrate on for the screening programme.
Unfortunately there are still many deaths from breast cancer each year. These deaths occur where the cancer is very vigorous or sadly in some cases where the cancer is not picked up early enough or is misdiagnosed.
Recent figures show that in general the UK cancer survival rates are amongst the worst in Europe. It is undoubtedly the case that medical experts believe that early diagnosis of the disease is critical to a good outcome in any treatment regime. Any delay in the diagnosis will therefore be very serious and in some cases have catastrophic results.
Breast cancer usually starts in the cells lining the lobes and tissues inside the breast. Tumours are created by an abnormal and uncontrolled growth of cells. Tumours can be either malignant or benign. Nine out of ten breast lumps are not cancerous.
The most usual symptom is the appearance of a lump. This is the commonest presentation to a GP. There is a specific plan for the treatment of lumps and this usually involves referral to a specialist unit for further tests usually a mammogram or biopsy .
In a few cases there may be a failure to refer the patient for further specialist treatment at this stage.
Nipple discharge can be a symptom of breast cancer. However in most cases it will have a much less sinister pathology. Failure to refer cases of nipple discharge to a specialist unit can lead to misdiagnosis or delay in diagnosis. There is a specific code to decide what steps should be taken when a patient presents with a discharge.
If the discharge is bloodstained or watery and can be localised to one duct a microdochectomy (excision of the affected milk duct) should be carried out to establish the cause of the nipple discharge. The longer the discharge has continued the greater the indication for further treatment. A patient with discharge should not simply be sent home without a date for a further review.
Because so few men suffer from breast cancer there are a number of misdiagnoses in this area. A lump in the male breast can be caused by the condition ‘gynaecomastia’. A delayed appointment for removal of the lump in the belief it is a gynaecomastia can lead to delay in the diagnosis if it turns out to be breast cancer. In most cases a biopsy should be performed on referral to the hospital, especially if there is any family history of breast cancer.
It can be the case that the biopsy result is difficult to read. Mistakes can be made at this stage.
On occasions it can also be the case that there is an erroneous diagnosis of the breast cancer. There can be a very fine line between a diagnosis of breast cancer and a benign tumour, even experienced histopathologists can have difficulty in correctly reading results. A false positive can lead to unnecessary invasive surgery and stress.
In order to make a claim for misdiagnosis or delayed diagnosis it is necessary to prove that the standard of care received from the relevant practitioner fell below the standard of care expected from a reasonable qualified practitioner. This will normally be by reference to the codes of conduct for cancer care.
It is also necessary that the delay has caused an adverse outcome. The delay has to be for a number of months before it is likely that the outcome will be affected. An oncologist can map the stage the cancer would have reached at the time it should have been diagnosed and compare this with the stage at the time of diagnosis. He will then be able to look at the statistics for a cure and compare these at each stage. It is necessary to prove that the delay was the cause of the adverse outcome. It is not enough to say that there was an increase in the chance of an unfavourable outcome.
Legal Advice should be sought as quickly as possible, so that any potential claim can be pursued. There are strict time limits in place to make any injury claim. If these are not adhered to the right to make a claim may be lost.