Dalton v Southend University Hospital NHS Foundation Trust [2019] EWHC 832 (QB) (03 April 2019)

C seeks damages for alleged clinical negligence resulting in a delayed diagnosis of breast cancer… the issues of breach of duty, causation and contributory negligence to be determined at trial. [1]

In February 2011, C noticed what she describes as a small, hard lump in her right breast. She promptly consulted her GP, who referred her to the breast clinic at Southend Hospital. The referral letter records a finding on clinical examination of a 2-3 cm lump in the upper outer quadrant. [3]

C attended the breast clinic on 8 March 2011. It is common ground that she underwent assessment, including clinical examination, a mammogram and ultrasound, but no biopsy, and that she was reassured and discharged. By November 2013, she had noticed further changes in the same area of her right breast. Her GP referred her back to the breast clinic. A large Grade II ductal carcinoma was diagnosed. [4]

C’s case is that she should have undergone tissue diagnosis in March 2011 and that this would have detected the cancer at that stage. [5]

D denies this… a biopsy was not mandated on the basis of the clinical examination and radiography findings in 2011. C would not have undergone a biopsy in his unit and that this is in accordance with the national guidelines for patients referred to hospital breast units. Even had a biopsy been performed, it is D’s case that the tumour is unlikely to have been detected due to its small size. The parties agree that it is likely to have measured about 3mm in diameter at the time. [6]

C has not established any breach of duty…. not have been persuaded that causation was made out. [80]