'Scandal' of unnecessary breast ops

More radiotherapy facilities needed, says Dr Sikora

A woman's chance of losing a breast to cancer is twice as high in some parts of the country, according to an audit of operations.

And a leading cancer expert says hundreds of women were having unnecessary mastectomies because there are not enough radiotherapy facilities.

He highlighted a voluntary audit by 400 surgeons in the NHS breast screening programme which showed wide variations in the mastectomy rates across the UK.

In the south-east, 12% of women had mastectomies, but in the north-west and north-east, the rate was as high as 30% in some hospitals.

It seems intrinsically unfair that those living in certain areas should have a poorer quality of service in the 21st century

Professor Karol Sikora,
WHO cancer programme head

The difference is not explained by their symptoms, he said, as the women in the audit had tumours of less than 2cm in diameter - which would not normally lead to breast removal.

He will say in his speech: "Overstretched radiotherapy services simply cannot cope with the extra work of routine breast radiotherapy so pushing women to have unnecessary mastectomies.

"It seems intrinsically unfair that those living in certain areas should have a poorer quality of service in the 21st century."

Shock

Speaking to BBC News Online, Professor Sikora, visiting professor of cancer medicine at the Hammersmith Hospitals, London said he was very shocked when he saw the audit results.

And he said the shortage of radiotherapy facilities and staff would be a problem for a few years to come, despite extra investment by the government.

Professor Sikora estimated that the NHS needed an extra 100 radiotherapy machines.

The NHS Cancer Plan, said lottery money would be used to replace 45 machines - which he said was not enough.

Professor Sikora, head of the World Health Organization (WHO) cancer programme, said cancer funding in the UK needed to at least double to keep pace with developments in prevention and treatments.

"The way forward is to de-politicise the cancer message, and have politicians, experts and patients look at the issue."

He said a broader range of sources should be examined for funding for cancer care, including private funding, should be explored to boost the cash available.

"We need to have a massive amount of money coming in. We need to at least double current levels."

He also said the NHS needed double the existing number of cancer consultants, mainly from non-surgical areas.

More investment needed

The investment into cancer services outlined by the government would only address the shortfalls in the existing situation, he said, not cater for the developments that would take place over coming years.

Professor Karol Sikora: call for failings in cancer services to be addressed

He added: "Britain is so far behind in terms of infrastructure. We are set for a massive change in the way we receive cancer care. and we're not up to speed on the present situation.

He will say in his speech that the target times for breast cancer diagnosis have not been met.

In 1997, 50% of targets were diagnosed within the 14-day target. In 1999, the figure was 44%.

The percentage meeting the target for first treatment of diagnosed breast cancer within 21 days also fell, with 77% met in 1997 and 74% in 1999.

Professor Sikora believes the figures will continue to fall.

Professor Mike Richards, the government's National Cancer Director, told the BBC: "We are putting more funding into services and that is specifically for more machines and more staff, and we will have an unprecedented number of new machines going in."

He said there would be 101 new radiotherapy machines over the next three years, with 26 in place before the end of this year.

Delyth Morgan, chief executive of Breakthrough Breast Cancer, said: "We would be concerned that anyone with breast cancer is not being offered or informed about a full range of treatment options.

"There is clearly a need for better staff resources. The NHS identifies this as a priority; the Cancer Plan states it is working towards better staffing and treatment facilities by 2004.

"However, this report emphasises that need should be addressed as soon as possible."