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Breast cancer Covid delays: ‘How many women are out there like me, wandering around not knowing?’

Susan Daniels at home in Glynneath, South Wales - Jay Williams
Susan Daniels at home in Glynneath, South Wales - Jay Williams
Coronavirus Article Bar with counter ..
Coronavirus Article Bar with counter ..

Susan Daniels should have had her routine breast cancer screening appointment towards the beginning of this year. Aged 60, she had for the past 10 years been diligently attending the check-ups to which all women over 50 are invited.

But after moving house in January, she missed a letter calling her for a screening. By the time her mail had been redirected to her new home in Glynneath, South Wales, the appointment had passed.

“In March, I phoned to rearrange it, but by then all the screening had been put on hold because of the pandemic,” she says. “It was frustrating, but I accepted I had to wait.”

A couple of months later, however, the mother of one, who works for a civil engineering company, found a lump in her left breast. When, two weeks later, it was still there, she phoned her GP who saw her that day and referred her for rapid diagnosis.

“Two weeks after that, I was told I had cancer in both breasts,” she says. “I knew there was something not right, and you prepare yourself for someone to tell you there’s a problem. But it was an awful moment. It was like an out of body experience. It’s life-changing. You start looking at things differently. Even now it causes a lot of anxiety and sleepless nights. It’s just a horrible situation.”

Mammograms have been delayed by the pandemic - Juice Images/Alamy Stock Photo
Mammograms have been delayed by the pandemic - Juice Images/Alamy Stock Photo

Yet in finding the lump herself, Daniels was one of the lucky ones. This week, new figures from Breast Cancer Now suggest as many as 9,000 cases of the disease may have been missed this year after screening services were halted during the coronavirus pandemic. The charity estimates that almost a million women have missed their mammograms since lockdown was imposed in March – with dire consequences for a sizeable minority.

The aim of suspending routine screening was to reduce the spread of Covid-19 and free up doctors to tackle it. But while well intentioned, the decision has had heartbreaking consequences for those suffering from other conditions.

For every woman like Daniels, who managed to get a diagnosis, there will be many more unaware they have a problem.

“I did ask the surgeon what would have happened if I’d ignored [the lump] and she said it would have grown,” she says. “I sympathise with why [the suspension of screening] had to happen. I understand it was [the result of] lots of knee-jerk reactions to keeping people safe. I was never angry about it, but I was frustrated because now there’s a backlog. How many women are out there like me, wandering around and not knowing?”

Since her diagnosis, Daniels has undergone a bilateral lumpectomy, had lymph nodes removed for a biopsy (though fortunately it turned out the cancer hadn’t spread), and had surgery to remove potentially cancerous cells. In two weeks’ time, she will begin a course of radiotherapy.

Fall in assessments

But others have not received treatment in such a timely manner. The pandemic has seen a significant fall in the number of patients with any type of cancer being assessed and treated.

Figures for England show that the number being assessed by a cancer doctor after referral dropped by 60 per cent in April, compared with the same month last year. The number of patients starting treatment dropped 20 per cent below the 2019 number.

For many, the results will be devastating. Previous research by Breast Cancer Now found that women with incurable breast cancer may have their lives shortened as a result of not being able to undergo chemotherapy, have diagnostic scans to monitor their progress or take part in trials.

A paper published in The Lancet medical journal in July estimated that there would be a 7.9 to 9.6 per cent increase in the number of deaths due to breast cancer in England up to year five after diagnosis, due to Covid-related delays.

Michelle Bailey, 37, is among those whose treatment was disrupted by the pandemic. After being diagnosed with fast-growing and invasive breast cancer at the start of March, she was told she would need a lumpectomy, chemotherapy and radiotherapy. A few weeks later, with hospitals across Britain in the grip of the crisis, things completely changed.

“I was told ‘There’s been disruption to your treatment plan’,” says the mother of one from Stockport, Greater Manchester. “Instead, I would need a single mastectomy. It was a lot to take in. I’d prepared myself and talked to my son about it. To go back and be told ‘We can’t do that now,’ was a shock. But I had no choice. It’s left me a bit bitter. I don’t think I was fully prepared mentally for the operation.”

Michelle Bailey had to undergo a mastectomy after her initial treatment was delayed
Michelle Bailey had to undergo a mastectomy after her initial treatment was delayed

She was brought in for the surgery as a day patient at Wythenshawe Hospital during lockdown. Since then, there’s been little follow-up. “To this day, I’ve not actually had an examination of the area I was operated on,” she says. “My GP did a FaceTime call with me to look at the site because I was concerned about a build-up of fluid there as it was so sore.

“There was no physiotherapy afterwards, no support other than from charities. They’re the only places I’ve been able to get help and information. I know it’s not the hospital’s fault, they’ve been under so much pressure, but I do feel a bit neglected.”

She counts herself lucky that she was diagnosed when she was. When she first tried to get her breast lump checked with a GP in early March, the surgery was already insisting on phone consultations for all but “emergency” cases. It was a locum doctor who sent her for an urgent referral.

“It’s so important for women to get checked, regardless of what’s going on in the world,” she says. “They removed all my cancer, but there are people out there who haven’t had half the treatment they need.”

How to clear the screening backlog?

Breast Cancer Now warns that unless the backlog of women who haven’t been checked this year is dealt with swiftly, there will be even more delayed diagnoses.

“Screening is a really important tool for promoting early diagnosis,” says Baroness Delyth Morgan, the charity’s chief executive. “The problem is we’ve got this enormous backlog. How do we make sure that gets dealt with, rather than building up further? We need to have a very clear and energetic plan for tackling it.”

The NHS says the vast majority of cancers detected through screening programmes are at a very early stage and so any impact on patients who were due to be screened is “extremely low”.

A spokesman says: “More than 200,000 people were treated for cancer during the peak of the pandemic, breast screening services are now fully up and running, with over 400,000 women invited between June and August and thousands more invites are now being sent every month.”

But Baroness Morgan doesn’t think the problem is likely to disappear overnight. “There’s a huge amount of pressure on the system at the moment and I’m worried this will get lost and other priorities will come to the fore,” she says. “If we don’t tackle this then in a year’s time the impact on women could be really serious and getting out of hand.”

For information and support, visit breastcancernow.org

Have you had a breast cancer screening delayed? Let us know in the comments section below or share your story with us at yourstory@telegraph.co.uk.