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Tuesday, 18 September, 2001, 14:27 GMT 15:27 UK
Breast test lottery 'may risk lives'
Breast tumour x-ray
Breast cancer can be unpredictable
A leading breast cancer specialist says patients' lives are being put at risk because of the way a key breast cancer test is carried out.

A survey of 229 British breast cancer units, carried out by Gordon Wishart, a breast surgeon at Addenbrooke's Hospital in Cambridge, found a glaring lack of consistency in the way doctors carry out oestrogen receptor (ER) testing.

The ER test establishes whether the tumour is stimulated by the female sex hormone oestrogen - the result of which is crucial in deciding what form of treatment is required.

Looking for oestrogen receptors enables doctors to assess how well a patient would respond to hormone therapy.

If the tumour is responsive to oestrogen, treatment - such as tamoxifen - can be given which blocks this effect, thereby hopefully slowing its growth and spread.

Huge discrepancy

Nearly two-thirds of tumours from pre-menopausal women and three-quarters from post-menopausal woman contain detectable oestrogen receptors.

But at some hospitals, only 5% of women "tested positive", while at others, it was as many as 80%

The researchers believe that the way the tests are being carried out means that some centres are missing hundreds of women who are ER-positive.

Mr Wishart, who presented his findings at the Nottingham International Breast meeting on Tuesday, said: "The measurement of hormone receptor status in all primary invasive breast cancer should become the standard of care.

"This study shows that it is not - with the result that women may be receiving poorly targeted treatment that can potentially lead to treatment failure."

Tracy Williams, senior cancer information nurse at Cancer BACUP, said: "Testing breast cancer tumours for receptor status is a vital step in tailoring individualised treatment to achieve optimum outcome and in selection for appropriate clinical trials.

"All women with breast cancer should therefore have equal access to testing that is carried out to agreed standards and techniques - the result of which would lead to standardised high quality care wherever they live in the UK."

The research also found that a follow-up test that may help cancer patients is not even carried out by some cancer units.

Mr Wishart found that only 35% of centres surveyed measured progesterone receptor (PR) status in all their patients, even though tumours found to be oestroen receptor negative are often PR positive and may still respond to hormone treatment.

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The BBC's Neil Bennett
"Cancer charities say testing should be carried out to agreed standards and techniques"
See also:

23 Aug 01 | Health
Cancer patients 'choose chemo'
12 Oct 00 | Health
Elderly 'unaware of cancer risk'
28 Sep 00 | Health
New drug 'better than tamoxifen'
19 May 00 | Health
Breast cancer deaths plummet
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