Home Health news Breast cancer fears for almost 1,500 women at ‘very high risk’ of disease after NHS blunder meant they weren’t invited for annual check-ups

Breast cancer fears for almost 1,500 women at ‘very high risk’ of disease after NHS blunder meant they weren’t invited for annual check-ups

by Editor

Nearly 1,500 women at ‘very high risk’ of breast cancer have missed potentially life-saving annual check-ups because of an ‘historic’ blunder.

NHS bosses have written to every woman affected, apologising for the error which dates back 20 years.

Health Secretary Victoria Atkins said an urgent catch-up programme will offer all of the 1,487 women a scan in the next three months.

Charities today demanded ministers acted to ensure that another failure of this kind never happened again.  

Health Secretary Victoria Atkins said an urgent catch-up programme will offer all of the 1,487 women a scan in the next three months. Charities today demanded ministers acted to ensure that another failure of this kind never happened again

Health Secretary Victoria Atkins said an urgent catch-up programme will offer all of the 1,487 women a scan in the next three months. Charities today demanded ministers acted to ensure that another failure of this kind never happened again

Officials have written to each woman affected, apologising for the error and offering an urgent scan. The error meant women who received radiotherapy treatment above the waist for Hodgkin lymphoma between 1962 and 2003 were not contacted to attend annual screening check ups for breast cancer

Officials have written to each woman affected, apologising for the error and offering an urgent scan. The error meant women who received radiotherapy treatment above the waist for Hodgkin lymphoma between 1962 and 2003 were not contacted to attend annual screening check ups for breast cancer

MailOnline understands approximately 1,200 of those are already enrolled in the NHS breast cancer screening programme. 

Women over 50 are invited for a mammogram every three years.

The error only applies to women who received radiotherapy treatment above the waist for Hodgkin lymphoma between 1962 and 2003.

As a result of that treatment, they face a heightened risk of getting breast cancer, a disease that strikes around 55,000 British women each year. 

Guidance issued two decades ago by the chief medical officer ruled that women in this category should get annual MRI checks as part of a scheme to spot the disease earliest, when survival rates are highest. 

Q&A: Who is affected by the blunder?

Which women are affected by the blunder?

The error only applies to women who received radiotherapy treatment above the waist for Hodgkin lymphoma between 1962 and 2003.

As a result of that treatment, they face a heightened risk of getting breast cancer, a disease that strikes around 55,000 British women each year. 

What went wrong? 

Guidance issued two decades ago by the chief medical officer ruled that women in this category should get annual MRI checks as part of a scheme to spot the disease earliest, when survival rates are highest. 

Clinicians were asked to contact both previous and current patients to refer them for annual checks.

NHS bosses were informed last year that some women were never invited, however.

When did ministers become aware of the error? 

Ministers were notified of the issue last month. 

The NHS wrote to all of the women affected by the issue yesterday. 

What happens now?

Health Secretary Victoria Atkins said an urgent catch-up programme will offer all of the 1,487 women a scan in the next three months. 

Clinicians were asked to contact both previous and current patients to refer them for annual checks.

NHS bosses were informed last year that some women were never invited, however.

Follow-up investigations found roughly a third of women covered by the ruling were not given the yearly scans. 

The NHS has insisted it has been transparent about the issue and sought to reassure women that they would all be ‘urgently’ offered a catch-up scan within the next three months. 

Ministers were notified of the issue last month. 

Health authorities have also identified a ‘much smaller historic group’, whose details are currently being verified and they will be written to in the coming weeks.

Addressing the blunder in the House of Commons, Ms Atkins said: ‘This letter addresses a historic issue where women who received radiotherapy above the waste to treat Hodgkin lymphoma and therefore were at higher risk of breast cancer were not given annual checks.

‘The NHS wrote to the 1,487 women affected yesterday in order to inform them.

‘We expect all women to be offered a scan within the next three months, and NHS England has established a helpline and briefed GPs and relevant charities.

‘The vast majority of this group of women will have already been receiving screening on a three-yearly basis.’

‘But of course NHS England wants to ensure they receive annual tests in line with the clinical guidance.’

Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: ‘We’re deeply concerned that certain women known to be at a very high risk of breast cancer have not been offered the vital screening that they are entitled to and would give them the best opportunity of detecting the disease early, when survival rates are almost 100 per cent.

‘This news will undoubtedly cause huge anxiety for the women affected and their loved ones.

‘It is vital NHS England take swift action to ensure these women receive the screening and support they need. 

‘The government and NHS England must also act urgently to identify and address the underlying issues that caused this error and provide firm reassurance that such a failure will not happen again.’

Women who’ve undergone radiotherapy above the waist for Hodgkin lymphoma do not start annual MRI testing immediately following treatment.

Doctors say the heightened risk of breast cancer doesn’t emerge until approximately a decade later. 

But in 2003, clinicians were asked to contact both previous and current patients to refer them for annual checks. This was not done. 

Symptoms of breast cancer to look out for include lumps and swellings, dimpling of the skin, changes in colour, discharge and a rash or crusting around the nipple

Symptoms of breast cancer to look out for include lumps and swellings, dimpling of the skin, changes in colour, discharge and a rash or crusting around the nipple

Checking your breasts should be part of your monthly routine so you notice any unusual changes. Simply rub and feel from top to bottom, in semi-circles and in a circular motion around your breast tissue to identify any abnormalities

Checking your breasts should be part of your monthly routine so you notice any unusual changes. Simply rub and feel from top to bottom, in semi-circles and in a circular motion around your breast tissue to identify any abnormalities

Officials said details of the 1,487 women who missed out were shared with NHS England in late September 2023, who identified the women affected. 

Ministers were notified of the blunder last month.  

Steve Russell, NHS national director for vaccinations and screening, said: ‘The NHS is contacting 1,487 women at increased risk of breast cancer due to having radiotherapy involving their chest for Hodgkin lymphoma, who may not yet have been offered additional annual screening.

‘While most of these women are already enrolled in the NHS Breast Screening Programme for regular mammograms, all women affected will now be offered support and invited for an annual MRI, and in most cases an annual mammogram, as soon as possible – the NHS will aim to complete this within three months.

‘We would like to extend our sincere apologies to those affected for any additional worry this may have caused.

Am I eligible for a mammogram? 

Women aged 50 to 71 are advised to have a breast screening every three years.

Women who are registered with a GP will be sent a letter inviting them.

At the appointment, X-rays called mammograms check the breasts for signs of cancer.

Results will be sent out in a letter, usually within two weeks. It will set out whether there is no sign of cancer or if further tests are needed.  

Breast screening saves around 1,300 lives each year in the UK. 

The chance of getting breast cancer increases with age and most are diagnosed in women aged over 50. 

‘Anyone who has had prior radiotherapy to their chest for the treatment of Hodgkin lymphoma and who is concerned they have not been invited for an annual MRI can call our dedicated helpline for support and further information.’

NHS England has set up a helpline for affected women, the details of which will be included in letters sent to them. 

It will also undertake a review of the process that refers these women into the most appropriate service for their risk to mitigate any future impact of this issue. 

An NHS England spokesperson said: ‘We are taking this very seriously and the NHS will do everything possible to ensure these women will be offered appropriate screening, at speed, in a compassionate and respectful way which is tailored to their clinical history.’

A Breast Screening after Radiotherapy Dataset (BARD) was set up in 2021, which uses national datasets and undertakes checks with treating centres with the aim to ensure all women at increased risk of breast cancer following radiotherapy are referred to the NHS Breast Screening Programme in line with national guidelines.

Prior to 2021, NHS England said its screening services relied on referrals from individual genetic services, family history clinics and radiotherapy centres.

In a ministerial statement, health minister Andrew Stephenson said: ‘NHS England wrote to a group of women who are at Very High Risk of breast cancer who have been eligible for annual MRI checks, but who may not have been routinely referred to the annual tests recommended in NHS guidance.

‘A number of women who were eligible for more regular “annual” testing did not receive it. This was due to variable referral processes.’

It comes as cancer charity Breast Cancer Now warned in January that more than 13,000 women with breast cancer may have missed out on an earlier diagnosis because the NHS had repeatedly failed to hit screening targets.

Fewer than two in three women (64.6 per cent) took up their screening appointment in 2022/23, according to NHS England.

This is a small improvement from 62.3 per cent the previous year but performance has fallen short of the NHS ‘minimum target’ of 70 per cent since 2019/20.

Breast Cancer Now called for a national awareness campaign to improve screening uptake. 

Breast cancer is one of the most common cancers in the world and affects more than two MILLION women a year

Breast cancer is one of the most common cancers in the world. Each year in the UK there are more than 55,000 new cases, and the disease claims the lives of 11,500 women. In the US, it strikes 266,000 each year and kills 40,000. But what causes it and how can it be treated?

What is breast cancer?

It comes from a cancerous cell which develops in the lining of a duct or lobule in one of the breasts.

When the breast cancer has spread into surrounding tissue it is called ‘invasive’. Some people are diagnosed with ‘carcinoma in situ’, where no cancer cells have grown beyond the duct or lobule.

Most cases develop in those over the age of 50 but younger women are sometimes affected. Breast cancer can develop in men, though this is rare.

Staging indicates how big the cancer is and whether it has spread. Stage 1 is the earliest stage and stage 4 means the cancer has spread to another part of the body.

The cancerous cells are graded from low, which means a slow growth, to high, which is fast-growing. High-grade cancers are more likely to come back after they have first been treated.

What causes breast cancer?

A cancerous tumour starts from one abnormal cell. The exact reason why a cell becomes cancerous is unclear. It is thought that something damages or alters certain genes in the cell. This makes the cell abnormal and multiply ‘out of control’.

Although breast cancer can develop for no apparent reason, there are some risk factors that can increase the chance, such as genetics.

What are the symptoms of breast cancer?

The usual first symptom is a painless lump in the breast, although most are not cancerous and are fluid filled cysts, which are benign. 

The first place that breast cancer usually spreads to is the lymph nodes in the armpit. If this occurs you will develop a swelling or lump in an armpit.

How is breast cancer diagnosed?

  • Initial assessment: A doctor examines the breasts and armpits. They may do tests such as a mammography, a special x-ray of the breast tissue which can indicate the possibility of tumours.
  • Biopsy: A biopsy is when a small sample of tissue is removed from a part of the body. The sample is then examined under a microscope to look for abnormal cells. The sample can confirm or rule out cancer.

If you are confirmed to have breast cancer, further tests may be needed to assess if it has spread. For example, blood tests, an ultrasound scan of the liver or a chest X-ray.

How is breast cancer treated?

Treatment options which may be considered include surgery, chemotherapy, radiotherapy and hormone treatment. Often a combination of two or more of these treatments are used.

  • Surgery: Breast-conserving surgery or the removal of the affected breast depending on the size of the tumour.
  • Radiotherapy: A treatment which uses high energy beams of radiation focused on cancerous tissue. This kills cancer cells, or stops them from multiplying. It is mainly used in addition to surgery.
  • Chemotherapy: A treatment of cancer by using anti-cancer drugs which kill cancer cells, or stop them from multiplying.
  • Hormone treatments: Some types of breast cancer are affected by the ‘female’ hormone oestrogen, which can stimulate the cancer cells to divide and multiply. Treatments which reduce the level of these hormones, or prevent them from working, are commonly used in people with breast cancer.

How successful is treatment?

The outlook is best in those who are diagnosed when the cancer is still small, and has not spread. Surgical removal of a tumour in an early stage may then give a good chance of cure.

The routine mammography offered to women between the ages of 50 and 70 means more breast cancers are being diagnosed and treated at an early stage.

For more information visit breastcancernow.org or call its free helpline on 0808 800 6000

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