Quebec says it is prepared to order new tests for breast-cancer patients after a study raised the spectre of flawed laboratory tests for hundreds of women.
Health Minister Yves Bolduc said he won't know until early next week when he will be able to inform patients if they were given the correct treatment, but he's not ruling out the possibility of testing patients' tissue samples again.
"There are thousands of patients who have cancer and who received treatment. Did they get the good treatment?" he asked yesterday. "Some people perhaps didn't get treatment and should have received it."
Cancer support groups expressed alarm yesterday over revelations that some breast-cancer patients may have received incorrect results on their pathology tests, which are key to determining their treatment. Cancer specialists said it's premature to call the situation worrisome, however.
The study by the province's association of pathologists, which has been pressing the government for more resources for pathology, found that some Quebec women may have received inadequate or ineffective treatment due to faulty assessments.
The group sent tissue samples from 15 breast-cancer patients to outside labs for retesting.
Findings showed that tests to identify markers that indicate a need for hormone therapy were flawed in up to 20 per cent of cases, as were up to 30 per cent of tests for the HER2 protein marker that indicates the drug Herceptin is necessary.
Louis Gaboury, president of the pathologists' group, said he initiated the study after Newfoundland's breast-cancer scandal. He called the results troubling.
"There's no one to validate the quality and robustness of the tests. It's a critical issue," Dr. Gaboury said in an interview.
Unlike several other provinces, Quebec has no quality-assurance program to ensure that laboratory test results are reliable, he said.
"We were disappointed because we think all we do is perfect, but the fact of the matter is, the situation in pathology is far from perfect in Quebec."
Dr. Gaboury and the head of Quebec's federation of medical specialists, Gaétan Barrette, said Quebec health officials have been aware of weaknesses since 2005.
Dr. Barrette said that while the study involved breast-cancer patients, its findings can apply to all cancers.
"It doesn't matter if it is liver cancer, bone cancer, lung cancer or a brain tumour. The issue is that quality is a problem in pathology."
Breast-cancer survivors said patients will wonder if their results were correct.
"You're asking yourself, 'Was this treatment even appropriate for me to begin with?'" said Deena Dlusy-Apel, a member of the board of Breast Cancer Action Montreal. "It makes you ask, 'Whom can we trust, and can we trust anyone at all after so many errors?'"
Specialists urged caution about the study, saying that 15 is a small sample, and the results were not made public yesterday.
"My message is clear, don't get alarmed today," said Sarkis Meterissian, director of the Cedars Breast Clinic of the McGill University Health Centre. "Wait until everyone can read this report."
Some also questioned the independence of the study, which received $60,000 from the pharmaceutical company Hoffmann-La Roche, maker of Herceptin.
"Industry funding is frowned upon as far as collecting data," Dr. Meterissian said.
A special telephone line will be open in Quebec today for cancer patients seeking information and advice.
The Ministry of Health and Social Services said it will act quickly, although it had not yet received the study by yesterday afternoon.
While not dismissing the study, Mr. Bolduc suggested that certain protocols may not have been followed, which could invalidate some of the results. He also noted the sample was small, and the source of funds suggested "corporate interests may be involved."