Women are not always to blame for delayed breast cancer diagnosis

http://www.theguardian.com/commentisfree/2015/apr/13/women-breast-cancer-delay-diagnosis-nhs

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In the summer of 2013, as I pulled on my swimming costume, I became aware of something slightly odd about my left breast. It wasn’t exactly a lump, more an area that felt a tiny bit different. I was pretty certain it was nothing, but I know how important it is to get checked. So I wasn’t one of the 30% of women who, according to research released by Breast Cancer Care today, wait a month to visit their GP after spotting a possible symptom. Instead, I went to my surgery and queued up for a same-day appointment. By the time I got to the front of the long queue, the female GP who I tend to see had no appointments left. Instead I was offered the chance to see a locum. I agreed. Best not to wait, I thought.

I have to stress at this point that I was convinced I hadn’t got a problem: maybe my confidence transferred itself to the locum when I saw him later that morning. On the other hand, he is a doctor. I am not. He examined me, and pronounced me fine. Off I skipped, thrilled to have my fears, however remote, quashed by a professional.

Five months later I noticed a slight puckering in exactly the area of my breast I’d asked the doctor about. I wasn’t sure if it was my imagination – it was almost imperceptible. But I’ve listened to all the messages about checking your breasts. I took myself straight off to the surgery again, and this time I insisted on an appointment with the woman GP who I’ve seen before. The receptionist said if I insisted on seeing her, there would be a three-week wait. Again, I agreed.

It was an anxious time, because now I was becoming more and more convinced that the puckered skin meant something was wrong. But my GP was reassuring when I saw her: she was, she said, 95% certain it was nothing. All the same, if I wanted a referral she was happy to give me one. I did, and at this point the “two-week rule” kicked in, and I was given an appointment at my local hospital’s breast clinic the following week. There, the mammogram showed no problem: but the story from a biopsy was different. Five days later I was told I had breast cancer. My tumour was lobular, notoriously hard to spot on a mammogram; these usually don’t present as a distinct lump (and that was the case for me too). To diagnose the extent of the cancer effectively, I was told, I needed an MRI scan. Given that I’d been fobbed off for months, and that I now knew I definitely did have a malignant tumour, I assumed this would be immediate. But I was told there would be a three-week wait.

It’s no good rushing a woman through a breast clinic for her to be told the crucial test can’t happen for three weeks

At this point I decided to use the private health insurance available through my husband’s job. The consultant virtually begged me to use it: as a result, I was given an appointment for an MRI scan three days later.

I am just one woman, and this is just my experience. But to anyone reading today’s research, and believing women are generally at fault, I want to tell you this. Late diagnosis of breast cancer is sometimes down to women delaying going to see their doctor, sure. But sometimes, too, it is down to the health service failing to respond effectively to a woman who is waving her arms above her head, saying: “Help! I think I have breast cancer!” So by all means women should be reminded to act on their suspicions: but we also need to make sure that when they do, and they’re justified, the health service does the right thing by them too.

For the record, after surgery and radiotherapy I am now doing well. I bear no ill feeling towards that locum, although with hindsight I think when a woman aged 50, who hardly ever darkens the surgery door, comes to see her GP with even the tiniest shred of worry about her breasts, she should be referred to the proper experts. I also think health service managers should stop just ticking boxes: it’s no good rushing a woman through a breast clinic for her to be told the really crucial test can’t happen for another three weeks. And I think people should stop making women feel bad about “delaying” seeing their doctor, when the equally worrying delays are those they encounter within the NHS.

Related: 17% of women diagnosed with breast cancer 'waited over a month to see GP'