Breast cancer patient burst into tears after finding out she was given unnecessary treatment at KTPH


A 46-year-old woman with breast cancer revealed that she burst into tears after finding out that she was one of those who was given unnecessary medical treatment at Khoo Teck Puat Hospital (KTPH), since she experienced weeks of side effects as a result of the misdiagnosis.
Last month, KTPH admitted that about 90 breast cancer patients may have received “unnecessary treatment” after the human epidermal growth factor receptor 2 (HER2) test that is used to guide breast cancer treatment produced inaccurate positive test results.
HER2 testing is performed in breast cancer patients to determine how aggressive the cancer is likely to be. The test is typically used to determine suitability for trastuzumab therapy, which is restricted to HER2-positive individuals as it is expensive and has been associated with cardiac toxicity.
For HER2-negative tumours, the risks of trastuzumab clearly outweigh the benefits. The side-effects of trastuzumab therapy may include heart problems, diarrhoea, chills and fever.
Based on the hospital’s initial estimates, about 180 breast cancer patients may have been inaccurately classified as HER2 positive when they were HER2 negative. About half of these patients may have received unnecessary treatment for HER2 and it confirmed that the treatment they received is likely to be trastuzumab therapy.
KTPH did not reveal when the issue was discovered but reported the issue to the authorities in late November 2020. It identified all the affected patients, stopped HER2 testing in its in-house laboratory and contacted patients to offer support after receiving retest results.
One of the affected patients, an accounting secretary, told the press that she was diagnosed with breast cancer in November 2019 and tested positive for HER2 around the same time. About a year later, she found out that she was among those who were actually HER2 negative and did not require more aggressive treatment.
Revealing that she suffered from weeks of side effects after she received 17 rounds of trastuzumab therapy, the patient said that she burst into tears when she realized that she underwent unnecessary pain:  “Thinking that I experienced unnecessary pain because of the use of drugs, I cried immediately.”
In addition to using the trastuzumab drug Herceptin, she also received radiation therapy and chemotherapy. During treatment, the patient suffered from side effects like hot flashes, insomnia, headaches, bone pain, chest pain and dizziness.
The patient said that she initially considered taking legal action against KTPH but ultimately decided against doing so: “At first, I was very dissatisfied with the unnecessary treatment, but we can’t go back to the past. Life is to look forward.”
Another affected patient, a 49-year-old customer service agent, had a different take. She said that she was not seriously affected by the unnecessary treatment and found the compensation KTPH offered sufficient.
Sharing that the cost of her medical treatment, including mastectomy, breast reconstruction and chemotherapy, amounted to about S$15,000, the patient said that KTPH’s compensation package even included miscellaneous fees like transport costs: “The compensation package provided by the hospital also bears my transportation expenses to and from the hospital and additional testing fees, so I think it is enough…”
She added: “I hope that if long-term side effects start to appear in a few years, the hospital will still take care of us.”
One patient, who resides in Hong Kong after moving there in 2014, has plans to initiate a legal case against KTPH. The 40-year-old said that she found a lump in her breast three years ago and was diagnosed with HER2-positive breast cancer.
The patient subsequently found that the lump tested negative for HER2 when it was surgically removed and sent to a laboratory for testing. An oncologist at the National Cancer Center also ordered a Fluorescence In-situ Hybridisation test which also came back negative.
Despite both negative tests, the woman’s oncologist advised her to continue using drugs to treat HER2 and even prescribed the more expensive drug, Pertuzumab. The patient used both drugs for a year, which cost between S$7,000-S$10,000 every three weeks. She also had to fly back to Singapore every three weeks for treatment over a six month period.
The patient only learned about KTPH’s inaccurate HER2 testing when she saw a news report on 11 December. She called the hospital on 12 December and discovered that she was among those who were misdiagnosed as HER2 positive. Irate, the woman is set on engaging a lawyer to seek compensation from the hospital.
KTPH has promised to give affected patients a full refund for the treatment and treatment-related expenses and has said that it has contacted over 75 per cent of the misdiagnosed patients already. A hospital spokesperson said:
“We are committed to maintaining regular contact with all affected patients and providing support during this time…Our hospital is ready to provide physical, mental and financial support to patients when needed.”
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