Dying mother urges BRCA patients to seek MRIs

Speaking after she settled an action against the HSE over care from University Hospital Limerick (UHL) and her GP, she said: “In November 2022, just 6 days after the birth of my second baby, I was diagnosed with incurable metastatic breast cancer” Picture: Brendan Gleeson

Women with the BRCA breast cancer gene mutation should insist on annual MRI scans, a young mother dying from breast cancer said at the High Court yesterday.

The mother of two, who is 37 and cannot be identified, urged other patients with the condition to learn from her situation.

The National Cancer Care Programme recommends there should be protected MRI and mammography slots for screening of asymptomatic carriers of the BRCA gene mutation, the HSE said, but in the woman's case these were not provided.

Speaking after she settled an action against the HSE over care from University Hospital Limerick (UHL) and her GP, she said: “In November 2022, just 6 days after the birth of my second baby, I was diagnosed with incurable metastatic breast cancer.” 

“Since then, I have learned that my incurable cancer not just could, but should have been prevented,” she said.

I learned through my legal case that based on my strong family history of breast cancer, I should have been tested for the BRCA2 genetic mutation much earlier than I eventually was in July 2021. I learned that I should have been referred in a timely manner for screening with annual MRI scans.

She added: “I learned that the mammograms I was eventually given in February 2022 were themselves not read competently.

“As a result of these multiple errors in respect of which my GP and University Hospital Limerick have now admitted negligence, my family and I will suffer the incalculable loss that I do not wish to dwell on.” 

She now wants to highlight screening for people with the BRCA1 or BRCA2 gene mutation. “Whether you are male or female, you need to insist on screening by annual MRI,” she said.

“The Irish and international guidelines all agree that MRI is the primary screening method when you have this mutation, particularly as a young person when your breasts are more dense. If a timely MRI had been done — as was required though I did not know it at the time — my cancer would have been diagnosed at a time when it was treatable.” 

Speaking with her husband, 38, at her side, she added: 

I asked the HSE to highlight this issue to their clinicians and in particular to their breast services at Limerick as part of the settlement of my case. Unfortunately, they refused to do this and so I must take this opportunity to highlight the issue.

In court Mr Justice Paul Coffey said the case was a heartbreaking situation. Barrister Patrick Treacy SC, instructed by Cian O’Carroll solicitors, said her cancer was discovered after issues with breastfeeding.

The UL Hospitals Group acknowledged the breach in its duty of care and said “this failure resulted in a delayed diagnosis which has had devastating consequences for you, your husband, and your two children.” 

They added: “For this failure we offer our sincere and unreserved apologies to you and to your family We are truly sorry that you will be denied the opportunity to be there to support your husband and children.” To her family they said: “We are truly sorry you will not have the chance for many more years together.” 

GP Elaine Kolshus separately apologised for failing to refer the woman for genetic testing.

A HSE spokeswoman said: “Developing services to identify and support people with a genetic predisposition to cancer is a priority for the NCCP (national cancer control programme)”.

A new model of care for hereditary cancer was launched in June. This includes the MRI recommendation and services for these vulnerable patients.

“Implementation of the model of care will be a multi-year project and will require adequate funding and resourcing,” she said.

The Marie Keating Foundation, which supports cancer patients, states on its website that screening is offered to women with this mutation from the age of 30. 

"From age 30 women are screened with annual MRI and after 40 years of age digital mammogram is also performed. When a woman reaches 50 years, the radiologist will decide whether your breast tissue is dense and if it is necessary to continue with MRI in addition to mammograms. Women will continue to be offered annual mammograms for the rest of their lives and you can request that mammograms are performed at your screening hospital," they advise.