herald

Saturday 21 July 2018

Women misdiagnosed by doctor but HSE rules out 270 breast cancer re-tests

St James’s Hospital
St James’s Hospital

A re-examination of the breast cancer test results for around 270 patients has been ruled out despite the doctor involved in their care misdiagnosing two other women with the disease.

St James's Hospital in Dublin, which has the country's largest cancer centre, has ruled out re-investigating the tests of the women, depite a request being made to Health Minister Simon Harris.

The decision follows revelations that a locum pathologist in the hospital misdiagnosed the type of cancer Dubliner Alison McCormack had in 2010, finding she had a form known as ductal carcinoma in situ (DCIS), which is not invasive.

Ms McCormack, who was then 35, went on to have her breast removed and a reconstruction but doctors said she did not need chemotherapy, RTE Investigates revealed.

The young mother was relieved when doctors told her she was lucky "as it's a cancer curable by surgery".

Lump

However, two years later she discovered a lump on her neck and she went back to St James's for more tests.

"I was told it was the original cancer that was back. It was a DCIS but had spread to my lymph nodes and up to my neck," she said.

Ms McCormack had a year of treatment, including six months' chemotherapy, the removal of lymph nodes and five-and-a-half weeks of radiation.

It was not until later in 2013 she had the strength to ask questions and after a meeting was arranged was told she had been misdiagnosed in 2010.

The type of cancer she had in 2010 was more serious than DCIS but the pathologist had misinterpreted her test results.

She learned the hospital knew of the misdiagnosis for months without telling her. Her solicitor Rachael Liston said if Ms McCormack had not asked questions she would never have found out.

An internal hospital report concluded that the "error could have been made by any competent pathologist".

The hospital conducted a review of the more than 300 breast cancer tests examined by the pathologist. They looked at 39 results with nine DCIS cases he was involved in. The review found a second woman had also been misdiagnosed.

Asked for his opinion, Professor Ian Ellis, a pathologist at Nottingham City Hospital, said two out of nine are "red flag type of errors" and a concern. He said he would recommend a re-examination of all the breast cancer test results.

Ms Liston told the Herald she took the unprecedented step of writing to Mr Harris last July to alert him to the public health concern and the need to review other cases. She received an acknowledgement but no information of any follow-up.

The minister forwarded the letter to his relevant officials and contact was made with the HSE.

A spokesperson for the Department of Health said: "The HSE advised that the look back exercise found no evidence of incompetence."

A wider review was considered not warranted in the circumstances.

Asked if the second patient whose cancer was misdiagnosed has been informed, a spokesman for the hospital said that "all relevant elements of the patient's care were discussed and eight years later the patient remains in normal clinical review".

Ms McCormack, who recently settled her compensation case against the hospital, has ongoing health issues.

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