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Herald on Sunday Editorial: Breast test inquiry now called for

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Life-and-death decisions are best undertaken in a calm and collected fashion. That, at least, is what you might hope for in a pathology lab, where tissue samples are examined for signs of cancer.

But, as our story this morning reveals, stressed pathologists are making errors in breast cancer diagnoses because they are being asked to deliver results within unrealistic time frames.

The Herald on Sunday has now reported on three cases in which women were subjected to disfiguring mastectomies after being wrongly diagnosed with breast cancer. Test results or tissue samples had been mixed up; women who had been given the all-clear were left untreated.

This week, Waikato pathologist Dr Ian Beer admitted an Auckland woman had a breast removed in December after he had wrongly diagnosed her with cancer. Her test results imitated those for disease and he was rushed. "When you are interpreting pathology, you shouldn't be rushed."

Beer persuasively argues that he and his colleagues are "being set up to fail". They want the deadline - currently five days for suspected breast-cancer specimens - doubled to 10 days, which is the turnaround time expected for other cancer diagnoses.

It is difficult to disagree with him. There is no clinical reason for the rush. The extra five days may add to the stress of the patient waiting for news, but they would not make a difference to eventual outcomes.

Officials have ordered an investigation into the bungles, but it is important that any inquiry be independent and charged with looking more widely at processes and procedures in the whole field of pathology.

The troubled transition in the provision of community laboratory testing from Diagnostic Medlab to Labtests in 2009 shook patients' confidence in pathology, and the latest developments are even more disturbing.

Given the choice between a quick result and an accurate result, no patient would opt for speed. We need an exhaustive audit to ensure that a demonstrated risk factor for horrific errors has been neutralised.

- Herald on Sunday

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