Tag Archives: breast cancer

Breast Cancer – the importance of “the triple assessment”

In 2009 Mrs L was referred to hospital by her GP under the urgent 2-week rule after finding a lump in her breast.  She was seen by a Surgeon and underwent an ultrasound scan and a mammogram.  She was diagnosed with a simple skin cyst which did not require treatment.

Over 2 years later the lump was larger and painful.  This time in addition to scanning and clinical examination, she was offered a needle biopsy in order to get a tissue diagnosis.  Sadly, this confirmed that Mrs L was suffering from invasive breast cancer and the lump being investigated was the same lump she had been assured was not cancer 2 years earlier.

Mrs L underwent breast conserving surgery and axillary node sampling which revealed that the cancer had metastasised i.e. spread to her lymph nodes.  As a result, she then needed 6 cycles of chemotherapy and additional radiotherapy  The chemotherapy made Mrs L extremely ill.  She suffered alopecia, stomatitis, constipation, nausea, tiredness and musculoskeletal discomfort.  She was left extremely anxious and the additional treatment she required has left her with a life long increased risk of developing other debilitating and unpleasant conditions.

Mrs L made an excellent recovery and was able to return to work despite the setbacks and she instructed Armstrong Foulkes to investigate whether the treatment she had received was acceptable.

Independent expert evidence was gathered from a Radiologist, a Breast Surgeon and a Clinical Oncologist.  On the basis of their expert opinion, a claim was brought for 2 reasons:

a)            The ultrasound scan in 2009 had been reported incorrectly, and

b)            Mrs L should have been offered a needle biopsy in 2009.  Together with the other investigations – radiological and clinical, a needle biopsy would have formed what is known as “the triple assessment”.

With the triple assessment in 2009, Mrs L’s cancer would have been diagnosed 28 months earlier.  She would have avoided the cancer metastasising and she would have avoided having any chemotherapy at all and  would have only needed radiology to breast and avoided having the area above her collarbone irradiated.

The NHS Litigation Authority acting for the Trust denied any wrongdoing and Mrs L had no alternative but to start court proceedings.  Shortly after, the Defendant opted not to continue to defend the claim and they made an offer in settlement.   After some negotiations, Mrs L accepted a reasonable offer in full and final settlement of her claim.

Ashleigh Holt – June 2015