'Blunders' in breast cancer treatment

Hundreds of breast cancer patients permanently damaged by radiation treatment have received a major boost to their claims for compensation from the Government.

The women, left with severe pain and paralysis of an arm due to nerve damage, learned that their injuries were due to excessive doses of radiation, inappropriately delivered during treatment.

A report from the Royal College of Radiologists has confirmed that the most likely explanation for the condition, known as brachial plexus neuropathy (BPN), was the physical movement of patients between radiotherapy treatment to the breast and radiotherapy to the lymph nodes in the lower neck and armpit. High doses were a secondary cause.

Dr Margaret Spittle, Dean of the Faculty of Clinical Oncology at the College, said that as a result, some areas of the body overlying nerves got higher doses of radiation than expected.

"Women may have been initially lying down with their head on a pillow for the first doses, and may have then been moved to a sitting up position for the dose to the lymph area, to better accommodate the equipment," she said.

Lady Audrey Ironside, founder and president of Rage (Radiation Action Group Exposure), a pressure group set up in 1991 to campaign against the risks of radiation treatment, welcomed the report yesterday. She was treated for breast cancer at the Royal Marsden Hospital, London, in 1980 at the age of 50. Two years later she began suffering pain and paralysis in her left arm. Now she is in constant pain, and bone tissue in her collarbone and some of her ribs has been destroyed.

"The report confirms the worst fears of several hundred women. We all suspected the cause. This is enormously helpful to our quest for compensation from the Government," Lady Ironside said.

Two leading radiologists reviewed the records of 126 members of Rage Breast (for women who have been treated for breast cancer), and BPN due to radiotherapy was found in 48 women treated between 1980 and 1993 at 15 of 51 cancer centres in England and Wales where Rage members had been treated. A higher incidence of BPN was linked with some centres than others.

The report found that 41 of the cases occurred prior to 1987, suggesting that the incidence of BPN is declining as practice has changed. BPN is now rare, Dr Spittle said.

The report recommends that patients should be treated with radiation in a fixed position, that closer attention should be given to doses received by the tissues in the lower neck and armpit and that lymph nodes should continue to be treated selectively and not routinely as in the past. It says that every cancer centre should have a formal written procedure for treatment, and calls for clinical trials to determine the optimum radiotherapy regime.