Mammograms are unquestionably a vital diagnostic tool in the war against breast cancer. Since early detection of the deadly disease is the single most important factor in a successful course of treatment, women around the world are encouraged to undergo the procedure on a regular basis.
After a woman do their part by having the test done, she waits anxiously for a trained radiologist to read the scans and tell her if she is cancer-free or if there is any reason for concern and additional diagnostic procedures.
When a woman is told that there may be a problem, even if cancer is not ultimately found, the additional testing will effectively rule out the presence of the disease. When, however, a woman is told that her mammogram is negative for any sign of breast cancer, there is little for her to do except breath a sigh of relief and schedule her next appointment.
Thus, when a mammogram is misread and completely misses the presence of breast cancer in its early stages, the error has the potential of being nothing short of a death sentence for that woman. While such errors do occur, they are usually isolated and sometimes even understandable based on a number of variables involving the specific patient and the limits of the procedure itself.
It is therefore quite unnerving for women in general when they learn of a situation when one particular radiologist or laboratory has misread multiple sets of mammograms as being cancer-free when, in fact they were not. The results of such malpractice can be quite devastating and even fatal.
Such is the case right now with numerous mammograms read as being cancer-free by a supposedly qualified radiologist working at North Manchester General Hospital in Crumpsall and Tafford General in the UK. To date, at least 28 woman were wrongly advised their scans were negative when, if fact, they actually revealed the presence of breast cancer in its early and more treatable stages.
At least 17 of those woman are now suffering from advanced stages of the disease and are at serious risk of dying as a result of the misdiagnoses. The investigation into the matter only promises to uncover more examples of malpractice by this radiologist.
Although earlier reports were silent on some of the background of this case and did not identify the doctor involved, a late story in timesonline.co.uk has revealed that: “The doctor at the centre of one of Britain’s worst breast screening blunders was subject to an internal inquiry by his hospital 18 months before he was suspended, but no formal action was taken, The Times can reveal.”
“Colleagues were so concerned by his working practices that they alerted health chiefs at Trafford General Hospital in Greater Manchester just six months after he started work…The resulting delay in diagnosis has put 17 of them at significant risk of dying, the NHS trust confirmed.”
“The Times can reveal that he is Amjad Mohammad Ali Husien, an Iraqi-born doctor who has been a specialist radiologist for the past ten years. The radiologist became the subject of a major review after colleagues went to Trafford Healthcare NHS Trust again in April last year, two years after Dr Husien joined its staff. The report, published yesterday and first detailed in The Times, found that numerous misdiagnoses had “significantly altered” some cancer sufferers’ chances of survival.”
Stephen Jones, a solicitor for one of the women, said: "It was all the more so distressing because throughout the course of her treatment she had been reassured at every angle that everything was OK.” In his client’s case .
Some 2,495 scans reported on by Dr. Husien were retrieved and reread after concerns over the quality of his work last year. Of those, decisions for 238 patients were incorrect, and of that number, 28 women (so far) were told they were completely cancer-free have now discovered they are in advancing stages of breast cancer.
Seventeen women had their diagnoses delayed over three months. One woman went two years before being correctly diagnosed with breast cancer. At least one case involved multiple misreadings for the same patient.
Dr Richard Campbell, medical director at Trafford, said: "None have died. It is possible we think in 17 cases, out of 22, the delay in diagnosis was long enough that it might alter their outcome.”
While some experts are trying to quell concerns by calling this fiasco "an exception to the rule," the fact remains that many of these woman are going to die for no reason.
Chris Harrison, from Greater Manchester Strategic Health Authority (GMSHA), said: "On behalf of the health authority I offer my apologies to the women affected by this, and for the worry and distress caused, in particular to the patients whose cancer diagnosis became delayed as a result of this incident."
Accounts of how this situation came about include tales of a doctor who was probably working too much overtime and who was often the only radiologist on duty. His reports were therefore not immediately reviewed by another radiologist or countersigned by anyone.
The most glaring deficiency, however, seems to be the doctor’s failure in many cases to compare the most recent mammograms to available prior ones to see if changes had occurred.
We spoke to one experienced New York medical malpractice attorney who told us that “this seems to be the single most critical error, other than simply misreading what may have been there to be seen. When a radiologist has one or more prior mammograms or chest X-rays of a patient available for comparison, it is clear malpractice not to do so.”
“Sometimes a mammogram or X-ray looks clear or what is referred to as “within normal limits” when there is nothing to compare it to. However, when it is compared to a previous scan, the radiologist will see even the tiniest change and thus further investigation and testing can be ordered immediately.”
“In many cases, having a prior scan to use as a comparison is a life-saver and failing to make a comparison has often proven to be a fatal error on the part of a radiologist. Unfortunately, such medical errors cannot be undone and woman who trusted the mistaken results often pay for them with their lives.”