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SINGAPORE: At least 200 patients were wrongly classified as having a more aggressive form of breast cancer than their actual condition due to a laboratory error at the Khoo Teck Puat Hospital (KTPH), the Minister of State for Cheers, Koh Poh Koon. (January 4).
Authorities revealed last month that 180 patients were affected by a wrong diagnosis and half of them may have received unnecessary treatment.
The patients were wrongly classified as positive for HER2, a gene that controls how a healthy cell grows, rather than negative for HER2. This affects the way a patient is treated, usually with a drug called Herceptin.
Common side effects due to HER2-directed treatment include diarrhea, chills, and fatigue. About 3 to 4 percent of patients may also experience heart problems.
READ: Approximately 90 breast cancer patients may have received unnecessary treatment after inaccurate classification of 180 cases: KTPH
In response to parliamentary questions about the incident, Dr. Koh said that 200 patients had been reclassified from HER2 positive to HER2 negative as of December 23.
Of these, eight patients were treated in private hospitals and 192 patients in government-run hospitals. Eight patients are awaiting further tests.
“Joint care teams, comprised of KTPH surgeons, histopathologists, and treating oncologists, have been formed to review individual care plans for these affected patients, based on the change in HER2 status,” said Dr. Koh.
The hospital is also reviewing bills for affected patients, Dr. Koh said, adding that costs incurred by patients due to unnecessary treatments will be fully reimbursed.
The amount that will be reimbursed to each patient will depend on several factors, including the length of their treatment and the hospital they went to, he added.
“KTPH is also ready to provide any clinical and financial support to affected patients, including ongoing or follow-up treatment, if any, that may be required as a result of overtreatment,” Dr. Koh told the House.
The National Healthcare Group has convened an independent review committee, comprised of outside experts from various disciplines in the healthcare industry, to conduct a “comprehensive incident assessment” and recommend steps to improve the process. he said.
“This ensures that any gaps in the system are identified and addressed quickly to avoid the repetition of similar incidents,” he added.
KTPH began testing patients for HER2 in 2012.
Answering questions about the effectiveness of the test and why it took eight years for the problem to emerge, Dr. Koh said that the HER2 test is a complex process and that it took years for a significantly higher positivity rate of the normal. it was clear there was a problem with the results.
Dr. Koh also clarified that although KTPH is re-evaluating the 2012 results, it does not mean that all the results since 2012 were incorrect.
“It may well be that the errors have occurred in the last three or six months (but) KTPH is being prudent and careful in going back … until the moment the test began,” he said.
When Hazel Poa, a non-constituent member of Parliament, asked whether it is possible for these patients to receive free lifetime medical care as compensation, Dr. Koh rejected the suggestion as most of the side effects of HER2 treatment are temporary.
As for whether to offer mental health financial support to patients, Dr. Koh said the decision rests with the medical team helping the patient.
“A panic attack or an anxiety episode can happen with or without cancer, it can happen with or without treatment,” he said.
