Breast cancer: Was your medical treatment negligent?
Breast cancer is the most common type of cancer in the UK, with over 55,000 new cases each year. Breast cancer can affect both men and women of varying ages, however, the majority of breast cancer patients are women over the age of 50.
Even though there is lots of breast cancer awareness amongst doctors and the public, negligence can still occur, and failings in breast cancer care can have a devastating impact on a patient. Negligence can cause a patient’s symptoms to worsen and their cancer to spread, meaning that they need longer or more invasive treatment. Negligent failings can also minimise a patient’s treatment options and even shorten their life expectancy or, tragically, mean their cancer can no longer be cured.
What are the symptoms of breast cancer?
The symptoms of breast cancer will vary according to the type of cancer you have and the stage it is at. However generally speaking, the most common signs of breast cancer are:
- A lump or thickening in your breast or armpit;
- A change in size, shape or feel of your breast;
- Changes in the skin of the breast such as puckering or dimpling;
- A rash or redness of the skin;
- Fluid leaking from the nipple (in a woman who isn’t pregnant or breastfeeding);
- Changes in the position of the nipple
If you have any of these symptoms, you are advised to go to your GP, who can refer you for further tests if required. But how do you know if your care has been negligent? If it has been, what can be done?
In order to consider the common areas where breast cancer negligence may occur, it’s important to set out what ‘negligence’ actually means.
To be successful in a medical negligence claim, you need to prove that:
- The medical treatment provided fell below an acceptable standard, and that the medical professionals breached their duty of care by following a course of action that is not supported by a reasonable body of medical opinion (this is known as “breach of duty”); and
- That the breach of duty caused you to have a worse outcome, (i.e., you suffered injury and loss which would not have occurred if the treatment had been acceptable (this is known as ‘causation’)
If the treatment provided has been unacceptable and caused injury and loss, the patient will most likely be entitled to compensation.
Types of Negligence:
Unfortunately, medical treatment for breast cancer can sometimes result in a negligence claim for compensation. The main types of breast cancer negligence are:
- Delays in referral for tests;
- Delays/failure in diagnosis; and
- Inappropriate treatment (including a failure to provide treatment or incorrect treatment being provided)
Delays in referral:
Breast cancer is typically diagnosed when a patient either attends their GP and is referred for further specialist assessment, or during a routine mammogram screening. Women aged between 50 and 70 are invited for screening mammograms every 3 years in England and Wales.
The National Institute for Health and Care Excellence (‘NICE’) produces national clinical guidelines. The NICE recommendations for how patients with suspected breast cancer should be treated are detailed below:
|Symptoms||What should be done|
|Patient is aged 30 and over and has an unexplained breast lump, either with or without pain; or
Patient is aged 50 and over and has any of the following symptoms in one nipple only:
|The patient must be referred for suspected breast cancer for an appointment within two weeks
|Patient has skin changes that are suggestive of breast cancer; or
Patient is aged 30 and over with an unexplained lump in their armpit
|A referral should be considered for suspected breast cancer for an appointment within two weeks
|Patient is aged under 30 and has an unexplained breast lump, either with or without pain.||A non-urgent referral should be considered for an appointment that is outside the two-week period|
Whilst failing to comply with NICE guidelines does not necessarily prove negligence, it can sometimes be a very good indication that your treatment may have been inappropriate.
Patients who have attended their GP with any of the symptoms above and not been referred as advised may have a claim for medical negligence, if they can prove that this failure caused them a further injury.
Failure to diagnose
Even if a patient has been referred appropriately by their GP, there may a failure by the hospital to diagnose cancer. In respect of screening mammograms and/ or ultrasounds, the most common type of negligence happens when there is a failure to spot cancer on the mammogram. If breast cancer has been missed during a routine screening mammogram, it may be that this is then not picked up for a further three years – which could have a serious impact on the patient’s health. There can also be failings in histology, when biopsies are incorrectly interpreted and cancer is missed.
The type of treatment that you have will depend on the type of cancer you have, how advanced the cancer is, and what your general health is. Generally speaking, the most common types of treatment for breast cancer are surgery (to remove the cancerous tumour or all the breast tissue), chemotherapy, radiotherapy or hormone therapy. It’s not uncommon to receive a mixture of treatment options, to ensure that your cancer is effectively treated.
Once you have been diagnosed with breast cancer, you will most likely be under the care of an Oncologist or Breast Surgeon. Along with other doctors involved in your care, they will prepare a treatment plan. Unfortunately, the treatment that has been chosen or provided can sometimes be unacceptable. This can cause the patient’s cancer to spread, limiting their treatment options and life expectancy.
Common types of negligence in breast cancer treatment include:
Staging: once a diagnosis of breast cancer is made, it will be staged. This is to assess the level of that cancer – to see if it has spread (referred to as ‘metastasis’) to other areas of your body. The treatment you receive will depend on the type and staging of your cancer, so it’s crucial that this is done correctly. If there has been a failing to properly stage your cancer, you’re likely to receive inappropriate or insufficient treatment.
Surgery: surgery can be used to remove either the cancer (a lumpectomy or wide local excision) or all the breast tissue (a mastectomy). However, there can be negligence when the cancer is not properly removed, or if healthy breast tissue is unnecessarily removed. In the last few years, there have been numerous medical negligence claims for patients who have undergone ‘cleave sparing mastectomies’, a type of surgery that leaves some tissue behind, but means that the patient is at a higher risk of suffering a recurrence of cancer. There may also be problems with reconstructive surgery, leading to uneven breasts or scarring.
Monitoring: once the breast cancer is treated, patients will need to be monitored regularly to ensure that the cancer does not recur. If there are failings in monitoring, for example if this is not done appropriately or for long enough, there is a chance that the cancer could return and be missed, allowing it to spread.
Radiotherapy/chemotherapy: radiotherapy, hormone therapy and chemotherapy are used to eradicate cancer, however they also attack healthy cells. As such, they must be used only when required and appropriately to ensure that the cancer is treated and that any damage to healthy tissue is limited.
What can be done if medical negligence is suspected?
Patients who have suffered medical negligence for breast cancer are entitled to compensation. This compensation received is there to try and put the patient back in the position they would have been in had the negligence never occurred. The level of compensation awarded will be based on the extent of injuries and financial losses caused directly by the negligence. Compensation can be calculated by considering the unnecessary pain and suffering the patient has gone through, including any operations, scarring and any reduction in life expectancy, for example. Any financial losses will also be considered, and this can include past or future loss of earnings, past and future care, and past and future treatment, medications or equipment you may need (to give just some examples).
If you think you have been a suffered a negligent diagnosis of breast cancer, you can contact us our medical negligence team on 020 7288 4800. Our medical negligence solicitors have investigated many breast cancer claims, and continue to do so today. We have successfully obtained compensation for patients who have been injured due to negligence, and the families of patients who have passed away due to negligence.
At Bolt Burdon Kemp, we will fight to obtain the compensation that you deserve to move forward with your life. However, we appreciate that breast cancer negligence can be incredibly difficult to deal with, so we can also put you in touch with practical support services, to help you cope physically and emotionally.