S J Edney Solicitors were successful in securing compensation for a 50-year-old lady who suffered an 18-month delay in the diagnosis of breast cancer.
In June 2013, our Client attended her GP and reported the lump in her breast. She was examined and told that it was likely to be a muscle overlying her breast tissue and was normal.
18 months later, she re-attended her GP as a friend had suggested that she have the lump checked again. She was referred urgently to an Oncologist. Sadly, our Client was informed that the lump was breast cancer.
It was our Client’s case that a 2-week referral should have been made by the GP in June 2013, to a breast clinic in June and that this would have resulted in a diagnosis of breast cancer by the end of that month.
At this stage, the tumour would have been Grade 3 but would have been smaller; the diameter in 2013 would have been approximately 7 mm. The chance of a 7 mm grade 3 cancer being node positive is 25% (i.e. on balance of probabilities negative). She would also, again on balance of probabilities, not have had overt metastatic disease at that time.
Had our Client been referred in 2013 she would have undergone a wide local excision and sentinel node biopsy. She would have required radiotherapy to the remaining breast tissue but not to the supraclavicular fossa and neck. A debate about the benefits of chemotherapy would have been had given that this was a grade 3 lesion but at that size may well have been avoided.
Our Client thus underwent more extensive surgery than she would have required (mastectomy and axillary clearance, two delayed reconstructions and two revision operations) with the final outcome still problematic.
In addition, our Client was told that a lesion in her hip was likely to be metastatic. Whilst it was accepted that the delay was unlikely to have impacted on any metastasis, it was likely (on a balance of probability) that the metastasis would not have been picked-up with an earlier diagnosis and so our Client would not have been told that her prognosis was terminal.
Had our Client been re-examined and/or referred following her June 2013 appointment, it is likely she would have been diagnosed with breast cancer by end June 2013 and:
- with a 1.2cm poorly differentiated carcinoma which would not have spread to the lymph nodes – i.e. she would have been diagnosed with T1 N0 stage 1 and not T2 N1 stage IIB.
- would have undergone a wide local excision of the lump and sentinel node biopsy and avoided the mastectomy and axillary clearance. She would have avoided secondary scarring and loss of movement in the left arm, which causes a restriction in her social and domestic activity;
- would have been given a good prognosis, with the right iliac bone metastasis then invisible in microscopic form;
- would have responded well to adjuvant therapy, limited to breast radiotherapy and would have avoided chest wall radiotherapy and supraclavicular fossa radiotherapy. Our Client would have suffered a reduced period of inability to work and look after her daughter as a result.
- would have had a disease-free interval, with a good prognosis;
- would have avoided developing any symptoms from the right iliac bone metastasis for 3-4 years longer and with a likely 5-year better prognosis from the right iliac bone metastasis;
- would have had a 5% chance of developing lymphoedema as opposed to the now 13% chance, with the chance of sensory loss being reduced to 11% instead of the current 31%. As a result of the delay in diagnosis, our Client is at a more than doubled risk of lymphoedema. Further, our Client now needs to protect against the risk of infection due to increased risk of lymphoedema, including avoidance of certain activities such as gardening, abseiling and tree climbing.
- (ignoring the metastasis) would have had a 17.3% of not surviving her breast cancer for 10 years as opposed to her current 41.8% chance of not surviving her breast cancer for 10 years. As a result of the delay in diagnosis, our Client is at a more than doubled risk of recurrence of her breast cancer.
Our Client was unable to work due to the delay in diagnosis and prolonged period of treatment. She was fortunate in that she was paid in full by her employer during her absences.
Our Client was a single parent of a young daughter, who was residing at home with her during the initial part of her treatment. She relied up on friends and family to help around the home and to help care for her and her daughter.
What the Defendant said
The Defendant denied that they were negligent in their management of our Client. Specifically, they argued that despite the GP recording this as a ‘breast lump’ it was a lump higher than the breast and that this, coupled with our Client’s account of discomfort on movement, meant it was reasonable for this to have been treated as a muscle strain and not suspected breast cancer.
The Defendant denied liability (negligence) throughout.
Court proceedings were issued as the parties were unable to agree settlement.
The parties attempted to settle the claim during a ‘Joint Settlement Meeting’, but this proved unsuccessful.
With some further negotiations, we were able to settle the claim a few months before Trial.
S J Edney solicitors obtained compensation of £175,000.00 for this client in 2018