UPDATE: BOTCHED QUEBEC BREAST CANCER TESTS: PATHOLOGISTS QUESTION GOVERNMENT'S STANDARDS FOR DETERMINING TREEATMENT;

"AFTER THE RE-TESTING BY PHENO-PATH LABORATORIES IN SEATTLE, THE MINISTRY CONCLUDED THAT 87 WOMEN WERE GIVEN FALSE-NEGATIVE RESULTS AND AMONG THEM 39 RECEIVED IMPROPER TREATMENT BECAUSE OF IT. FIVE OF THE WOMEN IN THE GROUP DIED, BUT THE MINISTRY COULD NOT DETERMINE WHETHER THE DEATHS WERE LINKED TO ERRONEOUS PATHOLOGY HORMONE MARKER TESTS.

THE QUEBEC FEDERATION OF SPECIALISTS ARGUED YESTERDAY THAT IF THE STRICTER BENCHMARK HAD BEEN APPLIED, A MUCH HIGHER NUMBER OF WOMEN WOULD HAVE BEEN SHOWN TO HAVE RECEIVED THE WRONG TREATMENT.

"IT WOULD BE LIKE SETTING THE SPEED LIMIT ON HIGHWAYS TOMORROW AT 160 KILOMETRES PER HOUR. THERE WOULDN'T BE ANY MORE SPEEDING TICKETS," THE FEDERATION'S PRESIDENT, GAÉTAN BARRETTE, SAID, ADDING THAT GOVERNMENT WAS CREATING THE PERCEPTION THAT IT WANTED TO COVER UP THE FACTS.

REPORTER RHEAL SEGUIN; THE GLOBE AND MAIL;

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BACKGROUND: This blog has been following developments in Newfoundland, Quebec, and other areas of Canada which have been plagued by flawed cancer tests in order to remind readers that the problems in Canadian pathology are not restricted to its application in the criminal justice system - and the numerous miscarriages of justice involving Dr. Charles Randal Smith;

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"Standards used in Quebec for testing breast cancer tissue to determine treatment are being questioned by the province's specialists, leaving the Minister of Health scrambling to reassure patients," reporter Rheal Seguin's story, published earlier today in the Globe and Mail, begins.

"The debate focuses on how physicians decide whether the results of hormone receptor tests, which determine whether a breast cancer patient would receive estrogen-fighting drugs, are positive or negative," the story continues, under the heading "Standards for breast cancer tests queried" and the sub-heading "Debate erupts over whether results of hormone receptor tests are positive or negative."

"The tests determine the percentage of cancer cells with hormone receptors. Some doctors require a 10 per cent count before considering the result positive and ordering hormonal therapy. Others apply a much stricter standard of just 1 per cent.

On Wednesday, Health Minister Yves Bolduc released the results of new tests on tissue from 2,856 cancer patients after anomalies were detected last spring in the original pathology tests. The ministry used the less demanding 10 per cent as the benchmark for positive hormone receptor status.

After the re-testing by Pheno-Path Laboratories in Seattle, the ministry concluded that 87 women were given false-negative results and among them 39 received improper treatment because of it. Five of the women in the group died, but the ministry could not determine whether the deaths were linked to erroneous pathology hormone marker tests.

The Quebec Federation of Specialists argued yesterday that if the stricter benchmark had been applied, a much higher number of women would have been shown to have received the wrong treatment.

"It would be like setting the speed limit on highways tomorrow at 160 kilometres per hour. There wouldn't be any more speeding tickets," the federation's president, Gaétan Barrette, said, adding that government was creating the perception that it wanted to cover up the facts.

"What we need is to implement standards of practices in this province that are at the level of the best worldwide practices in pathology."

The Health Minister said there is no consensus in the medical community over what percentage is needed to determine hormonal treatment.

"The medical literature is not clear on this," Mr. Bolduc said. "What we know is that over 10 per cent you must give the treatment. At zero per cent you don't give the treatment. Between zero per cent and 10 per cent, it depends on the condition of the patient and it depends on the judgment of the doctor."

There is no better person placed to make the decision on what type of treatment is needed than the physician in consultation with the patient, Mr. Bolduc said.

He added that provinc ewide standards should be in place by next March that will include stricter quality control regulations for all of the province's 58 pathology laboratories.

Dr. Barrette said he couldn't understand why the Minister couldn't act immediately to reassure breast cancer patients who have endured enormous anxiety as a result of the retesting.

"What we say is that we cannot wait until March, 2010, to take a decision. It can be taken today. The science is there," Dr. Barrette said."

THE STORY CAN BE FOUND AT:

http://www.theglobeandmail.com/news/national/standards-for-breast-cancer-tests-queried/article1404864/

Harold Levy...hlevy15@gmail.com;