Clinical report into NHS Tayside breast cancer drug discrepancy says risk ‘very small’

NHS Tayside’s decision to reduce chemotherapy dosage to breast cancer patients below the national standard had a “very small” impact on patient risk, a clinical investigation has concluded.

The health board has said it lowered the dosage in 2016 to reduce side effects, but has since brought it back in line with other health boards in Scotland after criticism from Healthcare Improvement Scotland.

The scrutiny body had been called in after a whistleblower raised concerns over chemotherapy treatments in Tayside.

The new Immediate Review Group (IRG) report said the risk of reoccurrence of breast cancer had increased by the equivalent of one person per year.

However, it criticised the fact the board had not consulted national groups or patients before deviating from standard best practice.

“Whilst the decision to reduce doses in 2016 was taken in the best interests of patients, and based on an audit of toxicity, this decision lacked robust challenge or consultation,” the report said.

“It reflected a unilateral internal decision to adopt practice which was judged by the IRG as being outwith best current practice, and close to being unacceptable."

NHS Tayside is developing an action plan to deliver on the recommendations from Healthcare Improvement Scotland.

Commenting on the report, Scotland’s Chief Medical Officer Dr Catherine Calderwood said: “This report looks closely at the level of risk to women as a result of the different clinical practice in treating breast cancer in NHS Tayside. It concludes that the risk is very small, with the chance of a negative impact estimated at around one per cent.

“However, I absolutely recognise that current and former patients, and their families, may be concerned and have questions with regards to their treatment.

“It is important that anyone who has concerns about their treatment speaks with their oncologist.”