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Breast Cancer

Reasons to choose Wilson Browne

October is National Breast Cancer Awareness Month and as we have dealt with a number of clinical negligence cases, usually concerning a delayed diagnosis, we thought it would be a good opportunity to share what we have learnt with you.

There are a number of different types of breast cancer, but the most common is “Invasive Breast Cancer – no special type”. It used to be called ductal carcinoma so you might sometime hear it referred to as that too. No special type means that the abnormal cells don’t have any special features unlike other rarer breast cancers.

The possible symptoms of invasive breast cancer include:

  • a lump or thickening in an area of the breast
  • a change in the size, shape or feel of the breast
  • dimpling of the skin
  • a change in the shape of your nipple, particularly if it turns in, sinks into the breast, or has an irregular shape
  • a blood stained discharge from the nipple
  • a rash on a nipple or surrounding area
  • a swelling or lump in the armpit1

The positive is that survival of breast cancer is generally good and improving. According to Cancer Research UK around 80% of women will survive their cancer for 10 years and 65% for 20 years. Survival depends on lots of factors but the stage of your cancer at diagnosis is the most telling factor. The earlier cancer is caught and treated the better the prognosis.

Treatment for cancer will depend on the type of cancer, its grade and stage. You might have surgery, chemotherapy, radiotherapy, hormone treatment or a combination of treatments.

The stage of a cancer refers to the size of the tumour and whether or not it has spread to other areas of the body. Stage 1 cancer is the smallest and stage 4 the largest. In breast cancer, the first and most likely place a cancer will spread to is the lymph nodes. The lymph nodes are more commonly known as glands or lymph glands and we have them on each side of the neck, under the chin, around the groin and in the armpits. In cases of breast cancer where it has spread to your lymph nodes it will usually be those in your armpit.

If you are diagnosed with cancer, you will probably be told what grade and stage the cancer is. The grade of a cancer refers to how abnormal the cells are and cancers are graded from 1 to 3. A grade 1 cancer will have cells that are less abnormal and the cancer is a slow growing one. A grade 3 cancer is the most abnormal and fastest growing. The grade of your cancer won’t change.

Sometimes hospitals don’t refer quickly enough for further tests or don’t do the tests that they should. Once referred by your GP testing for breast cancer will usually involve a mammogram (an x-ray of your breast) and a biopsy or just the biopsy if you’ve been recalled following a routine mammogram. If you are under 30 an ultrasound is often used instead of a mammogram as it gives a better picture in young breast tissue.

Women between 50 and 70 are invited to routine mammograms to check their breasts for any early signs of breast cancer. It’s important that you attend if you’re invited to a mammogram as this is the best way of picking up breast cancer at the earliest possible time. If you think you may have been affected by the recent IT failure that meant thousands of women missed breast screening appointments you can read our article on it here.

Sadly, a lot of cases of medical negligence that we see relate to a delayed diagnosis where patients have seen their GP with symptoms of breast cancer but are not referred to hospital or a breast clinic quickly enough. Where diagnosis is delayed, it can allow the cancer to grow and make treatment for the cancer more significant or in the worst cases, could mean that treatment is less likely to be successful.

Your GP should refer you to a specialist breast clinic if you present with symptoms of breast cancer. If you are over 30 and have an unexplained lump in your breast, or you are over 50 and have discharge from or retraction of your nipple then you must be referred to a breast clinic for an appointment within 2 weeks. If you are under 30 and have a breast lump the referral might not be for an urgent appointment as it is less likely to be cancer. Wherever cancer is suspected you should be referred to a breast clinic for further tests.

It is also possible for men to get breast cancer. Male breast cancer is rare and according to Cancer Research UK there are only about 390 cases of male breast Cancer a year, compared to 54,800 cases of female breast cancer. The most common symptom of male breast cancer is a painless lump in the breast but any changes to the nipple or skin around the breast could also be a sign of a cancer.

Other types of breast cancer include Invasive Lobular Breast Cancer, Ductal Carcinoma in Situ, Triple Negative Breast Cancer and Inflammatory Breast Cancer. We previously acted for a lady who developed Paget’s Disease which is a rare form of breast cancer that starts off with a rash around the nipple that looks like eczema. She was not diagnosed as soon as she could have been and you can read about her story in the case study below.

The list is not exhaustive and if you notice any changes to your breasts you should seek advice from your GP. It’s really important to check you own breasts regularly to have the best chance of identifying any changes quickly. Earlier diagnosis and treatment will much improve the chances of successful treatment and may also mean that the treatment will be less invasive. Anyone who has been though cancer, or knows someone who has, will know that often the treatment for cancer can be more challenging than the disease itself.

Case Study - Delayed Diagnosis of Paget's Disease

We acted for a lady in connection with a delayed diagnosis of Paget’s Disease which is a form of breast cancer.

The claim was investigated against the GP practice and also Northampton General Hospital as it was considered that a number of GP’s who had seen her had delayed in not referring her to the hospital and then when she was referred to the Hospital, the Consultant Breast Surgeon failed to carry out a punch biopsy. If these tests had been carried out then the diagnosis could have been made 5 or 6 months earlier.

Due to the delay in diagnosis the client had to undergo a left mastectomy which we accepted would have been the treatment even if a diagnosis had been made earlier but she would have avoided having to have chemotherapy and radiotherapy treatment and also having to take Herceptin and Tamoxifen.

The case progressed and proceedings were issued at court. We relied on evidence from a Consultant Breast and General Surgeon and also on a Oncologist. The claim against the General Practice was discontinued and the hospital admitted liability but initially denied causation. Shortly after exchange of expert evidence the Defendant’s made an offer of settlement which our client accepted.

The case settled for a five figure sum.

Our Medical Negligence team deals with cases of all types and complexity. Medical Negligence can apply to many conditions but people often refer to it in the context of ‘operations gone wrong’. Such a narrow term does not even begin to cover how many situations come under the banner of Medical Negligence.

We can work with those representing the potential defendants to achieve a settlement and compensation for you as quickly as possible.

We are happy to offer a free initial telephone consultation with a member of our specialist team and subject to agreement we can offer no win – no fee agreements.