“Epidemiological Follow-up 15 Years After Presumably False Diagnoses of Breast Cancer” – A Statement by the German Senology Society

In 1996 a suspicion arose with regard to a group of patients in Essen diagnosed with breast cancer. It was suspected that a certain pathologist was making incorrect diagnoses, that carcinomas were being diagnosed in cases where no oncological disease was present. When the findings of the pathologist under suspicion were rechecked, the diagnoses initially appeared plausible; however, DNA analysis showed that the pathologist in question had – clearly in an attempt at deliberate deception – presented false histological sections and tissue specimens.

The extent of the pathologistʼs misconduct, which was gradually emerging, led to an investigation by the Public Prosecutorʼs Office. A fire broke out in the pathologistʼs laboratory which appeared to have been started by the pathologist himself. The accused pathologist met his death in the fire and all patient records were lost, which made it impossible to subsequently correct any individual diagnoses and reassure any of the patients affected.

In view of the facts there can be little doubt that the pathologist behaved culpably, even though precise information cannot be obtained about the number of cases in which an incorrect diagnosis of “breast cancer” was made, either deliberately or due to negligence.

The current article by Hauth et al. presents data from the 15-year follow-up of the affected women and compares this data with the expected data of women who were correctly diagnosed with breast cancer. The study once again confirms that it is very probable that the majority of women who were diagnosed with breast cancer by the pathologist at the time and who subsequently underwent treatment in the form of operative intervention, chemotherapy or hormone therapy did not have oncological disease. It was found that the survival rates of patients in Essen were much higher compared to the rates for a comparable collective of patients with breast cancer.

The German Senology Society is grateful that this scientific follow-up of the affected women means that this monstrous and luckily unique event has not been forgotten. The case goes to the heart of the medical profession: it strikes at the trust our patients place in us and the trust that medical colleagues place in each other.

Every day we take life-changing decisions together with and on behalf of our patients. More than in other social areas we depend on the accurateness of the facts available to us and the correctness of the information we use to make these decisions.

Interdisciplinary work depends on communication and communication depends on trust: trust in the proven competence of our partners and trust that the quality control systems which serve the interest of the patients entrusted to us will quickly flag up any issues.

Criminal intent of the sort displayed in the case above – whatever the motives were for these acts – only serves to emphasise the value of trust – and the true meaning of the old saying “trust is good – control is better”.

The efforts of the German Senology Society and the German Cancer Society to systematise and centralise the diagnosis and therapy of the most common malign tumours affecting women, to ensure that the attending physicians who treat patients are competent, and to guarantee the quality of the interdisciplinary chain of competence through regular external controls must be seen against this background. These are the core elements of the extraordinarily successful certification of German breast centres according to DKS/DGS, a certification which is considered internationally as exemplary.

Our patients are entrusted to our care. The consistently high standards of quality demanded of breast centres, the safeguarding of highly relevant diagnoses by internal peer review, and the constant statistical evaluation all aim to protect our patients. But they also protect us as physicians working within a network of professional trust from such incalculable vagaries, which in the case discussed here brought harm to many women in an unprecedented manner.