Two women had their breasts removed unnecessarily after being misdiagnosed with cancer at the Royal Darwin Hospital.

One of the women, Rachel (not her real name), shared her story with the ABC’s 7.30 in the hope of helping others avoid the nightmare she endured.

Rachel, 60, moved to Darwin late in 2012 to support her daughter-in-law and grandchildren while her son, a soldier, was posted to Afghanistan.

In July 2013, after getting a routine mammogram, she had a biopsy tested at the Royal Darwin Hospital and a senior surgeon brought her the devastating news that she had breast cancer and her whole left breast would need to be removed “urgently”.

“And it was performed rather quickly, within two weeks,” she said.

Just weeks later, Rachel was called in to see her surgeon at the hospital.

“And that’s when he said to me: ‘I’ve got good news and bad news to tell you: the good news is you don’t have breast cancer.

“The bad news is you never did have breast cancer and we should never have taken your breast off’.”

‘If you’re in pain, get on a plane’

Slowly Rachel began to realise the full magnitude of the error.

“I started to really feel the impact of that, the horror of that mistake. How dare they make this mistake?” she said.

“I lost faith in the medical system in Darwin. In fact, after it happened to me, all the colleagues I worked with said, ‘Oh, don’t you know? You live in Darwin. The saying is: you feel the pain, book a plane. And this information came to me after, a little bit late.”

7.30 has confirmed Professor John Skinner was the pathologist responsible for misdiagnosing Rachel in 2013.

The hospital said that after identifying the error himself and reporting it to the hospital, Professor Skinner continued to work there for several months before his retirement, with some restrictions on his practice.

However, Rachel’s case was not unique.

A 25-year-old breastfeeding mother in Alice Springs was also misdiagnosed by Professor Skinner and had a mastectomy.

While Rachel has been compensated by the hospital — the details of which she cannot disclose for legal reasons — the young mother is yet to receive compensation for the 2013 mistake.

7.30 has learned Professor Skinner mistook the natural changes in the breast from her pregnancy for cancerous cells.

A ‘rather serious and tragic error’

Dr Charles Pain, executive director of medical services at Top End Health Service, which oversees the Territory’s hospitals, told 7.30 it was a “rather serious and tragic error”.

“The changes that occur in relation to breastfeeding, which obviously changes the nature of the cells, was confused with this kind of pathology, cancerous pathology,” he said.

Dr Pain said the two patients were notified as soon as the errors were realised.

“I would call it an interpretation error,” he said. “Pathology unfortunately is an imprecise science. It’s really a matter of judgment as to what diagnosis you make. So that’s why we try and introduce — and have done since then — a double reading process so you actually get two pathologists looking at the same thing.”

7.30 has obtained an internal Darwin hospital email through Freedom of Information sent just after the mistakes were made.

It reveals the director of medical services ordered all breast biopsies be sent interstate for testing until the results of a review by the Royal College of Pathologists of Australasia were known.

‘The system needs to change’

Professor Skinner declined an interview with 7.30 but said he deeply regretted the mistakes he made and was “embarrassed and upset” about the ordeal, which came at the end of his career.

Now retired, he said the system at the Royal Darwin Hospital was dysfunctional at the time he worked there and needed to change.

He agreed tests should be seen by more than one pathologist, especially before surgery.

However, he stressed the onus should not be on the patient to ask, but rather built into the system, with weekly interdisciplinary reviews of all cancer diagnoses so mistakes could be spotted early.

An external review into the mistakes recommended the Royal Darwin Hospital’s pathology department make six key changes to prevent the problem happening again, including the requirement for two pathologists to review all histopathology cases, regular internal quality assurance reviews, better training and regular multidisciplinary meetings between pathologists reporting breast core biopsies, breast radiologists and breast surgeons.

The hospital said all were implemented.

Rachel’s focus now is on helping other women avoid the ordeal she went through.

“Please ask questions, don’t assume, don’t trust,” she said.
“It outraged the surgeon and it outraged me as time went by. To think the system wasn’t there to ensure it was an accurate test.

“This is your body. You have a right to be absolutely confident that the testing that’s being done within the health system at the moment is accurate.

“We have to raise awareness to women that you just have to have mistrust in the system that failed me, and another woman on the day and could fail any other woman in the future.”

– ABC