A WOMAN WHO claimed that a cancer screening at a Breastcheck mobile unit was carried out negligently has lost her case at the High Court.

In a lengthy judgement issued today, Ms Justice Niamh Hyland found no negligence when Siobhan Freeney was screened in June 2015 and it was reported as normal.

Furthermore, the HSE acted appropriately in not identifying the mother-of-two for clinical recall following the June screening, according to the judge.

Siobhan Freeney was subsequently diagnosed with breast cancer in December 2015 after she identified symptoms and was referred by her GP for a hospital assessment. 

The HSE had denied all claims.

Alleged negligence

The 59-year-old woman from Gorey in Wexford has not worked for some time and had to retire from her job as a special needs assistant last year due to the ongoing effects of her treatment for cancer.

In May 2010, she first felt a lump in her left breast. Following tests it was determined to be benign. She was subsequently referred to the Breastcheck service and received an initial mammogram in May 2011. 

She received two routine recalls, in May 2013 and June 2015.

In June 2015, Freeney’s screening was read by two radiologists. Neither felt a clinical recall was necessary. A clinical recall in this context is when a woman reports symptoms that a doctor then feels worthy of further examination or when such symptoms are observed by the radiographer at the time of the screening. 

When she later noticed symptoms in November of the same year, she sought medical attention and was diagnosed with breast cancer.

She received chemotherapy and also a mastectomy. The judge noted: “Happily, the treatment was successful and the plantiff is, at present, free of cancer.”

In her case before the High Court, she alleged the June 2015 screening was carried out negligently. She said she should have been clinically recalled and sent for further examination, which would have meant her cancer was diagnosed sooner.

While Siobhan Freeney accepted her treatment would have included a mastectomy in any case, she may have avoided chemotherapy and radiotherapy – and the side effects of these treatments – had she been diagnosed earlier. 

In her judgement, Ms Justice Hyland said that – to determine if the plaintiff had been harmed by the alleged negligence – she had to consider whether the cancer was present in June 2015 and if it would have been diagnosed had Freeney been clinically recalled at the time. 

Ruling

Evidence was provided by a number of witnesses, including the radiologists who read the test, the radiographer who completed the test and other experts. 

A note made by the radiologist who conducted the screening of Freeney describing her symptoms was made correctly in the judge’s view. As described by the patient, it did not warrant a clinical recall. 

In the exchange – according to this note – the patient referred to pain she felt in her right breast and was concerned about a lump in that area. 

According to the note, she agreed that this was not a new lump but she had “renewed concern over it because of the pain”. 

As she did not raise awareness to the radiographer of a new cyst, the fact that a clinical recall was not recommended fell within their guidelines. 

As the radiologists who analysed Freeney’s screening were also made aware of this note, the fact that they did not recommend a clinical recall was within the scope of guidelines on such matters, the judge found. 

Furthermore, after hearing evidence on the size of the woman’s tumour and how it had grown, the judge determined that it was a “true interval cancer”.

This is defined in the judgement as one that “showed normal or benign features in the previous screening mammograms”. 

The judge said: “I find that the plaintiff’s cancer was a true interval cancer, i.e. it showed normal or benign features in the screening mammogram of June 2015 and therefore reporting the mammogram as normal was not negligent.

Equally, the defendant (HSE) acted appropriately in not identifying the plaintiff for clinical recall following her screening in June 2015.

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