Delay in diagnosis of breast cancer

What happened

Ms N found a lump in her breast and her nipple started to invert. Her GP referred her to the Trust, where staff carried out a mammogram in early summer 2013. An ultrasound scan did not confirm any sign of disease. The Trust carried out an MRI scan the next month because doctors had not been able to make a diagnosis. The MRI scan was inconclusive and staff carried out biopsies the following month. Doctors diagnosed her with breast cancer and she had a mastectomy. This was almost eight weeks after Ms N was first seen.

What we found

We partly upheld this complaint. The Trust should have carried out biopsies at an earlier stage and, in line with relevant guidelines, performed a triple assessment (clinical assessment, mammography and/or ultrasound imaging, and core biopsy and/or fine needle aspiration) in a single visit. The Trust did not have the facilities to do this.

There was evidence that the Trust missed opportunities to arrange a needle biopsy (a procedure where some cells are taken from a lump using a fine needle under local anaesthetic) at the first assessment in summer 2013 (at the same time as the ultrasound scan) and again after the MRI scan. These delays meant that the diagnosis of the disease was similarly delayed.

There were also failings in the way Trust staff communicated with Ms N about her care before her diagnosis. After diagnosis, there were no problems in communication or support.

There was no evidence that the delay in diagnosis led to Ms N undergoing more aggressive treatment but it caused anxiety and stress because of the lack of diagnosis.

Putting it right

The Trust acknowledged the service failings we identified and apologised to Ms N for them. It paid her £500 in recognition of the worry and distress caused by the delay in diagnosing her cancer. It also drew up an action plan to make sure that lessons were learnt from these failings.