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At the heart of general practice since 1960

Breast cancer diagnosis delays put GPs in firing line

By Emma Wilkinson

Medicolegal experts have warned GPs that delays in diagnosis of breast cancer are a common cause of claims against GPs.

The MPS said of 1,000 consecutive negligence claims, 14% were for delayed referral and therefore diagnosis of cancer.

Advisors said 20 of those involved breast cancer and although the numbers seem small the issues is often preventable.

Dr Angelique Mastihi, MPS medicolegal adviser, said: ‘Another MPS study of complaints in primary care has confirmed that delay, and the perception that there has been a delay, whether or not this is justified, is the main reason for these complaints arising.'

Other cancers commonly appearing in negligence complaints are cervical and colon, the MPS figures show.

Guidelines issued by the MPS urge GPs to listen to women's concerns even when a mammogram or physical examination does not show anything untoward.

Dr Mastihi said: ‘One of the key messages here is that over 90% of breast cancers are found by women themselves.

‘When a woman says there is a lump in her breast, it is more than likely that this is the case'.

She also gave the example of a woman who mentioned a breast lump as an aside at the end of a consultation and this was not acted upon or recorded in the notes.

'In this case the fact that the patient was not examined initially and there were no relevant notes, meant that this patient had a valid claim for a delay in diagnosis'.

Dr Willie Hamilton, a clinical researcher in the Department of Primary Care at the University of Bristol, who specialises in cancer diagnosis, said although the number of successful claims was likely to be much less than 14%, the MPS guidelines made some good points.

'The problem is that cancer diagnosis is such an emotive subject and that almost every cancer could have been diagnosed quicker.

'But, I wholly agree with their pointers to good practice, which amount to three things - believe the patient, examine the patient and write it down.

‘It would be very unwise to dismiss a patient saying she has a breast lump without examining her.

‘It's harder if you can't find a lump, and in this case, surely reviewing the patient a week or two later is wise.'

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