Breast cancer screenings failing NZ women

By Martin Johnston

Photo / Thinkstock
Photo / Thinkstock

Serious problems in part of New Zealand's national breast cancer screening programme have led to delays in the diagnosis of the deadly disease in a number of women.

The Ministry of Health confirmed last night that faults had been identified in the BreastScreen HealthCare programme serving the women of Otago and Southland.

"The issue relates to the reading of mammograms," said the ministry's chief medical officer, Dr Don Mackie, who issued a written statement to the Herald, but did not return the paper's phone calls.

"An internal audit has identified that there may have been a delay in the diagnosis of breast cancer for some women," Dr Mackie said.

"This issue is being taken very seriously. A full and urgent investigation is jointly under way by senior officials at the ministry ... and Southern District Health Board, to confirm what has occurred and what actions need to be taken."

Other checks were being set up in the breast screening and assessment pathway, including a review by experienced breast screening radiologists external to the DHB.

The Herald understands around eight cases of women with breast cancer have been linked to the failings in the Southern DHB screening programme, although it was not clear last night whether the taking or reading of their mammograms (specialised x-rays) had been delayed or whether mammograms had been misinterpreted at the first reading.

The principle of early cancer diagnosis is at the heart of organised screening programmes, although the effect of delayed breast cancer detection on a woman's health outlook is uncertain.

Breast surgeon Dr Belinda Scott said it was preferable to diagnose breast cancer early rather than late, but: "We don't know whether it makes any difference ... or not.

"Because all cancers are different in their grading and their aggressiveness, we don't really know whether you are going to be making a difference to those women diagnosed later."

She sought to reassure women that the screening programme was safe and effective.

The issue is separate from earlier reported problems with the screening programme.

The Otago Daily Times reported in January that computer software problems at breast screening services in the lower North Island and the Southern DHB in 2009 had led to 241 women missing out on their two-yearly appointments for a mammogram.

Five were found to have cancer when they finally had a mammogram. Of them, two had been diagnosed by private providers between mammograms under the Government's screening programme, two had not been re-invited because they had not attended appointments in the previous screening round, and one woman due for her second routine mammogram was missed.

In December the Herald quoted a leading radiologist's letter warning the Government of risks to women posed by the screening programme's loss of key, long-serving staff.

The national breast screening programme was set up in 1999 and offers free mammograms to women aged 45 to 69. Organised cancer screening can save lives, but has had a rocky history in New Zealand.

Dozens of women developed cervical cancer and some died after under-reporting of cervical smears during the 1990s by former Gisborne pathologist Dr Michael Bottrill.

After a ministerial inquiry into the Gisborne scandal and shortcomings in the national cervical screening programme, which did not pick up Dr Bottrill's mistakes, 46 recommendations were made to fix the problems.


2700 number of new cases in 2008

624 number of deaths in 2008

* Women aged 45 to 69
* Mammogram every two years
* State funded


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