A review of thousands of mammograms flagged in late 2010 for possible errors has detected 109 breast cancers missed by a radiologist or one of his clinicians, Quebec's College of Physicians says.
The college ordered a review of 22,040 breast cancer screening tests conducted between October 2008 and October 2010, after a random quality control review in 2010 turned up problems with test interpretations.
Ninety-six of the 109 problem cases were missed by now-retired radiologist Raymond Bergeron; the remaining cases by colleagues at one of the three clinics that Bergeron ran — Radiologie Jean-Talon Bélanger and Radiologie Domus Médica in Montreal, and Radiologie Fabreville in Laval.
Work load blamed
College spokesman Dr. Yves Robert suggested the elderly radiologist was simply overworked.
"Probably he had a very high pressure to read a high level of films in a short period of time," Robert said. "It seems he had difficulty recruiting colleagues to help him do the job, so probably he was just overload[ed.] And this is the kind of situation that is at risk of making mistakes."
Bergeron, who is in his mid-70s, stopped practising medicine on Oct. 9, 2010.
The college's review included about 500 CT scans and resulted in a callback of 158 patients for a repeat of their scans. An official said the scans were done on such old equipment they were essentially useless.
The college has recommended better oversight of radiologists, digitizing mammograms to make them easier for others to consult and more uniform standards for private clinics.
The recommendations are good, but come too late, according to Jean-François Leroux, whose Montreal law firm represents nine women considering or already taking legal action against Bergeron.
"It's something that should not have happened," Leroux said. "These recommendations were known and should have been put forward years before now."
Solo work is the problem, radiologists say
The Quebec Association of Radiologists called the findings unfortunate and insisted this is an isolated case.
"Age is not the problem," said association president Dr. Frédéric Desjardins. "It's more that with age, doctors tend to work alone."
Desjardins said the association encourages radiologists to work in teams, in order to monitor each other's work.
'My God, it's terrifying...You know your cancer is advanced. You don't know to where.' —breast cancer patient Louise Le Brun
"My God, it's terrifying," said Louise Le Brun, one of the women who got a clean bill of health from Bergeron. "You know your cancer is advanced, [but] you don't know to where."
A year after her test, she found out she had advanced breast cancer. She's since had two surgeries, radiation and chemotherapy.
"I lost a big part of me, and I was mad," she said, "The delay was too long."
Health minister defends system
In 2009, the college brought in a quality control program after a scandal over faulty pathology test results for hormone markers linked to breast cancer.
Quebec Health Minister Yves Bolduc said he is open to making improvements, but added the fact the college's audit detected the mistakes shows the system is working.
Nevertheless, Le Brun said, she would have preferred better oversight from both the college and from her radiologist.
"You have to do your job!" she said. "And a good job — because it's the life of the patient."
Still, the mother of four said she feels lucky because doctors believe she may have beaten her breast cancer.