A SURGEON who failed to diagnose breast cancer in a woman who later died of the disease has admitted to a Medical Council inquiry that he should have sent his patient for a mammogram.
The surgeon, referred to as "Doctor C", made the concession on the second day of a fitness to practise inquiry into his treatment of a patient identified only as "Ms K".
The mother of one was diagnosed with breast cancer by Dr C in June 2008, nine months after he initially gave her the all-clear. He faces six allegations of professional misconduct, including that he failed to consider Ms K's medical condition, that he failed to carry out an adequate examination, that he failed to refer her to a specialist and that he failed to arrange for an adequate follow-up.
He is also accused of carrying out an ultrasound examination on Ms K when he was not qualified to do so.
He said at the time he first saw Ms K, the system for checking for breast cancer in his area was not satisfactory.
He said patients were waiting at least three and as many as 18 months for the now standard triple assessment examination – an investigation which involves clinical examination, mammography and pathological examination. He said he had taken a course in the use of ultrasound and used it to decide which women should be sent for an immediate mammogram and triple assessment.
He said all women who did not receive an immediate examination would eventually receive triple assessment in a number of months anyway.
Dr C told the inquiry that when he received a referral letter from Ms K's GP, he assigned her immediately to a triple assessment appointment for August 1, 2007. He said after she failed to turn up, he thought she should be given the benefit of the doubt, and so she was booked in for another appointment which she also failed to attend.
He agreed that on her third appointment, Ms K was not booked in for a triple assessment but instead for a general assessment with access to the triple assessment clinic.
"Here we have a lady that has declined to attend us on two appointments, it would be very unusual if she was worried about something," he explained.
Under cross examination, Dr C said after examining Ms K with his hands and with ultrasound he came to the conclusion that the lumps in her breast were benign When asked by counsel for the CEO of the Medical Council, Rory Mulcahy, if he was correct in his decision, Dr C replied, "retrospectively, unfortunately I was not".
The inquiry is expected to hear from one final witness today before retiring to consider a verdict.