How has Covid Effected Breast Cancer Diagnosis and Treatment

How has Covid Effected Breast Cancer Diagnosis and Treatment

It has been widely reported that the Covid-19 pandemic had a profound impact on the investigation and diagnosis of cancer in 2020 but more recent studies are beginning to show the true scale of this effect.

The following statistics provide some insight into the detrimental impact of Covid-19 on cancer services generally: 

  • Between March and June 2019, 18,400 people in England had their cancer diagnosed at stage one. This fell by 33% to 12,400 in the same period in 2020.
  • The number of patients having cancer surgery fell by 11% in February 2021 compared with February 2020.
  • The NHS target is for 85% of patients to start their cancer treatment within a maximum of 62 days. This figure was 69.7% in February – the lowest recorded figure.
  • About 370,000 fewer people with suspected cancer saw a specialist between March 2020 and February 2021 compared to a year earlier – a 15% drop.
  • Based on an estimate by the Macmilliam cancer charity, it will take the NHS 18 months working at 110% capacity to catch up on missing cancer diagnoses and 15 months to clear the cancer treatment backlog.

How have breast cancer treatment services been affected by Covid-19?

The charity Breast Cancer Now has reported that since screening recommenced in the summer of 2020 there has been a reduction of approximately 500,000 women being screened compared to the same months in 2018 and 2019. The apparent effect of this reduction in breast cancer screening has been highlighted by a study estimating that in May 2021 there were 12,000 women in the UK living with undiagnosed breast cancer.

Normal breast cancer screening was withdrawn during the peak of the Covid pandemic to create capacity in the NHS to treat Covid patients and to avoid the spread of infection. Although services have been resumed, it has still been necessary to ensure that enhanced measures are in place to prevent the spread of infection and this continues to reduce the ability of the breast cancer screening services to offer as many appointments.

Prior to the Covid pandemic, the NHS was able to offer women aged between 50 and 71 a breast screening every three years and this had led to substantially improved survival rates for this terrible disease. However, it is estimated that there has been a 50% reduction in the number of women that have been screened since the start of the Covid pandemic.

It is widely acknowledged that the NHS are working incredibly hard to catch up on this backlog but charities and those working within the health service are calling for additional funding and staff to ensure that the screening services can meet demand.

The main concerns are that many women have experienced potentially harmful delay in their treatment or, even worse, have been overlooked as a result of a failure to refer them for screening when the early signs of breast cancer appear, in accordance with the clinical guidelines.

What do the breast screening guidelines say?

Breast cancer is a relatively common form of cancer, with approximately one in nine women developing the disease during their lifetime. Those over the age of 50 are particularly susceptible. To improve detection and survival rates, the NHS Breast Screening Programme was set up in England in 1988 to offer 3 yearly routine screening.      

The National Institute for Health and Care Excellence (NICE) guideline for “suspected cancer: recognition and referral” are as follows:

  1. Women are to be referred using a suspected cancer pathway referral for an appointment within 2 weeks for breast cancer if they are:
  • aged 30 and over and have an unexplained breast lump with or without pain, or
  • aged 50 and over with any of the following symptoms in one nipple only:
    • discharge
    • retraction
    • other changes of concern.
  1. Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for breast cancer in women:
  • with skin changes that suggest breast cancer, or
  • aged 30 and over with an unexplained lump in the armpit.
  1. Consider non-urgent referral in women aged under 30 with an unexplained breast lump with or without pain.

What are the early signs of breast cancer?

The most common sign of breast cancer noticed by women is a lump or an area of thickened tissue in their breast. However, the NHS recommend that women consult their GP if they notice any of the following:          

  • a new lump or area of thickened tissue in either breast that was not there before
  • a change in the size or shape of one or both breasts
  • discharge of fluid from either nipple
  • a lump or swelling in either of your armpits
  • a change in the look or feel of your skin, such as puckering or dimpling, a rash or redness
  • a rash (like eczema), crusting, scaly or itchy skin or redness on or around your nipple
  • a change in the appearance of your nipple, such as becoming sunken into your breast

It should be emphasised that most breast lumps are not cancerous, and that breast pain is not usually a symptom of breast cancer but it is recommended by the NHS that women see their GP if any of the above signs appear.

What should happen if my GP suspects breast cancer?

If your GP believes further investigation is required, a patient will be referred to a specialist breast cancer clinic.

The following tests may be performed by the breast cancer clinic depending on the patients’ precise presentation: 

  • A mammogram (an x-ray of the breast).
  • An ultrasound, particularly for younger patients.
  • Biopsy (the taking of a tissue sample from the breast)
  • Needle aspiration (taking a cell sample from the breast)
  • Needle biopsy (the taking of a biopsy from the breast by a large needle)

 

If breast cancer is diagnosed, further tests will be undertaken to establish the precise type of cancer, the stage and grade of the cancer and whether it has spread to other parts of the body.

 

What are the stages of breast cancer?

Stage 1 – the tumour measures less than 2cm and the lymph nodes in the armpit are not affected. There are no signs that the cancer has spread elsewhere in the body.

Stage 2 – the tumour measures 2 to 5cm, the lymph nodes in the armpit are affected, or both. There are no signs that the cancer has spread elsewhere in the body.

Stage 3 – the tumour measures 2 to 5cm and may be attached to structures in the breast, such as skin or surrounding tissues, and the lymph nodes in the armpit are affected. There are no signs that the cancer has spread elsewhere in the body.

Stage 4 – the tumour is of any size and the cancer has spread to other parts of the body.

 

What are the main forms of treatment for breast cancer:

  • Surgery – usually the removal of the lump or the removal of the whole breast (mastectomy), possibly following by reconstruction surgery.
  • Radiotherapy – usually provided after surgery and involves the use of radiation to kill cancerous cells. 
  • Chemotherapy – the use of medication to kill the cancerous cells.
  • Hormone therapy – therapy to reduce hormones that stimulate some breast cancers.
  • Targeted therapy – medicine, different to chemotherapy, that help stop the spread and growth of cancers.

Our expertise with late diagnosis of cancer claims

Our specialist clinical negligence solicitors have decades of experience handling compensation claims for late cancer diagnosis for people throughout England and Wales. We have successfully settled many claims for compensation where there has been a failure to provide timely treatment or where has been a misdiagnosis.

Our specialism is in handling complex and high value claims. Our experience includes cases involving misdiagnosis following the review of scans, failure by a GP to recognise cancer-related  symptoms, failure to refer the patient for specialist cancer investigation, delays with arranging tests and delays with reporting medical investigations.     

We are accredited by the Law Society for Personal Injury Law reflecting our expertise with all types of injury claims, including those involving clinical negligence arising from cancer treatment.

Our team has also been recognised by the two leading client guides to the legal profession Chambers & Partners and the Legal 500 for our exceptional skill in handling clinical negligence claims, with the Legal 500 ranking us Tier 1 for Personal Injury: Claimant.

How to start a delayed cancer diagnosis claim

We offer a free initial consultation to enable you to explain how you have been affected by the late cancer diagnosis and your concerns about the treatment. We will provide you with a clear preliminary assessment on the merits of your claim and set out the range of investigation to be undertaken to support your cancer claim.

We also offer no win, no fee agreements for Cancer Compensation Claims, meaning there is no upfront cost and no financial risk to you when you start a claim for with IBB.

To start a compensation claim for the delayed diagnosis of your cancer, call us today on 0333 123 9099. Alternatively, you can email us at enquiries@ibbclaims.co.uk or use the contact form on the right to request a callback.