Clinics missed 109 breast cancer cases: Quebec College of Physicians

Quebec's College of Physicians has found that a doctor who worked at three radiology clinics missed breast cancer in 109 women during routine mammography screening from 2008 to 2010.

That error rate is considerably high, and was committed primarily by one radiologist, who has since retired.

College president Charles Bernard acknowledged that some errors might have been committed by other radiologists at the three clinics under investigation, two of which are under new management and one of which has closed.

However, the College's investigation found that the error rate of those other radiologists was in line with provincial norms.

Bernard was also unable to provide the health status of the 109 women in whom breast cancer was later discovered. They have all started their cancer treatment and none has died.

The College of Physicians ordered that about 22,000 mammograms be re-evaluated after patients he deemed healthy later came down with cancer.

Breast Cancer Survival: The 5-year relative survival for female breast cancer patients has improved from 63% in the early 1960s to 90% today.

The survival rate for women diagnosed with localized breast cancer (cancer that has not spread to lymph nodes or other locations outside the breast) is 98%. If the cancer has spread to nearby (regional stage) or distant (distant stage) lymph nodes or organs, the 5-year survival is 84% or 23%, respectively. Relative survival continues to decline after 5 years; for all stages combined, rates at 10 and 15 years after diagnosis are 82% and 75%, respectively.

Caution should be used when interpreting long-term survival rates since they represent patients who were diagnosed and treated up to 22 years ago. Improvements in diagnosis and treatment may result in a better outlook for more recently diagnosed patients.

Many studies have shown that being overweight adversely affects survival for postmenopausal women with breast cancer and that women who are more physically active are less likely to die from the disease than women who are inactive. For more information about breast cancer, see the American Cancer Society’s Breast Cancer Facts & Figures 2009-2010 (8610.09), available online at cancer.org.

Quebec's mammography screening program saves lives and is highly accurate despite severe flaws uncovered at three Montreal-area clinics, the head of Quebec's association of radiologists said Monday afternoon.

Dr. Frederic Desjardins was reacting to the investigation by the College of Physicians.

Desjardins said this was an isolated case of an older doctor practising alone, and doesn't reflect the high standards of mammography screening in the province. Still, he said, his association will follow all of the College's recommendations, including the double reading of certain X-rays.