The director of cancer care services for the HSE in the midwest has warned he would find it "difficult" to continue his work in the health service if the assessment of suspected breast cancer cases does not improve.
Prof Rajnish Gupta, consultant medical oncologist at the Mid-Western Regional Hospital in Limerick, was speaking following revelations that a 51-year-old woman's diagnosis of breast cancer was delayed by 18 months because of test errors at University College Hospital in Galway.
Minister for Health Mary Harney has apologised to the Co Tipperary woman, who wishes to remain anonymous, and to her family. An independent review has been commissioned of pathology services at the Galway hospital. It is being conducted by the Health Information and Quality Authority.
Yesterday Prof Gupta revealed that the woman, who is undergoing chemotherapy, may not have needed such intensive treatment had she received a proper assessment in 2005.
"Although we hope this lady has a good prognosis, it should be stated that she may not have necessarily needed such intensive treatment had she received a formal and proper triple assessment in 2005," Prof Gupta said.
"If this kind of situation is allowed to continue involving patients with possible or proven cancer, I certainly for one would find it difficult to continue in this health service," he added.
The woman attended Barringtons private hospital in Limerick in September 2005 with a lump in her breast. The following day she underwent a mammogram, which was graded as classification five, which is "highly suggestive of malignancy", said Prof Gupta. A large lump was removed that day and the specimen sent to the pathology laboratory at University College Hospital in Galway, where it was mistakenly reported as benign.
In June 2006 the woman returned to Barringtons hospital with continuing concerns, and a mammogram was performed which, she was later informed, was normal. It was not until March of this year, when she again returned to the same private facility, that further biopsies confirmed evidence of cancer.
The woman underwent a mastectomy at Barringtons. Last April she was referred to Prof Gupta at the Mid-Western Regional Hospital, where she is undergoing chemotherapy.
"This lady should have been referred to a regional specialist breast unit and a multidisciplinary team at her original presentation in 2005," said Prof Gupta.
Had the woman been seen at such a specialist unit, the error would have been picked up in "two to three weeks", he said.
"Personally I am extremely disappointed, sad, angry and concerned that this has happened, that this was allowed to happen."
He said it was "indefensible" that Ireland had no national breast screening programme.
Prof Martin Cormican, clinical director of pathology at University College Hospital Galway, expressed regret for the errors. He told RTÉ: "The most immediate response is a sincere and deep apology to the woman and her family that an error was made here that has had an important impact on her life and her health.
"We recognise that we have a duty to this woman to learn whatever we can from what went wrong . . . and to take steps to reduce the risk of a similar error ever happening again."