Health: Breast scan consultants face censure

Two consultants at the centre of a breast screening alert are expected to be criticised in a report to the Commons today. Glenda Cooper examines the lessons learned from a health crisis which affected thousands of women.

Frank Dobson, the Secretary of State for Health, ordered the review of the East Devon Breast Screening Service by a team of experts led by the Chief Medical Officer, Sir Kenneth Calman, following concerns over the interpretation of breast scans of nine women, two of whom have died.

The six-year-old EDBSS is managed by the Royal Devon and Exeter Hospital Healthcare NHS Trust, which announced in June that its two consultants, Dr John Brennan, employed by the Royal Devon and Exeter hospital, and Dr Graham Urquhart, from Torbay hospital, were to have further training in breast screening.

The alert began after NHS medical staff raised concerns over 12 mammography films of women screened by the service.

The women developed cancer between the initial screening and before routine recall.

During hospital treatment, NHS medical staff expressed concern about the interpretation of tiny calcium deposits shown on the original mammogram film, and asked the NHS National Breast Screening Programme in Nottingham to review the 12 scans.

Problems were identified with interpretation of films of nine of the women, two of whom later died. The alert led to the review of almost 4,000 screenings.

About 2,000 women called helplines set up by the RDE Trust, the Exeter and Plymouth Nuffield hospitals where Dr Brennan also worked, and a private hospital in Torquay where both consultants also worked.

The women at the centre of the alert were among 60,000 screened by the EDBSS over a five-year period.

The Calman report is expected to say that the two consultants used outmoded and inappropriate treatment for abnormal test results.

Possible future changes could include increasing the number of mammograms by reducing checks from every three to every two years. But the cost of this change may prove prohibitive in the cash strapped National Health Service.

Some doctors fear that the two consultant radiologists will be made scapegoats and blamed for the problem as a quick fix political solution which would appease the public's unease.

The Calman report will reveal that there is room for improvement in general organisational and personal performances in the East Devon service.

The Government must now decide whether to spend more cash on a national review of the service. It could also decide to order independent monitoring of the breast screening service.

Meanwhile, the two radiologists will probably face disciplinary action by their healthcare trusts over their role in the affair.

The two radiologists have refused to comment about the inquiry findings from their respective homes in Devon. But it is understood they rejected as "invalid, inaccurate and unsubstantiated" personal criticisms levelled in a draft report. And it is thought they angrily reject any suggestions that they were "uncaring".

The Department of Health and the Devon Trusts also refused to comment last night.