THE treatment of 14 breast cancer patients who died during a period when some cancer patients were being given lower than normal without their knowledge are to be investigated.

It comes days after NHS Tayside bosses admitted that 304 patients treated after December 2016 were given 75mg doses of the chemotherapy drug Docetaxel instead of the standard 100mg used in the rest of Scotland in a bid to limit side effects, despite a lack of regional clinical consensus and criticism by those opposed to the lower dosage that it was based on a "selective" interpretation of the clinical evidence”

The drug can help to prevent breast cancer from spreading or returning, but survivors and bereaved families have hit out amid fears that the practice may have shortened lives.

Of the 304 women treated in this way for breast cancer between December 1 2016 and March 31 2019, 14 have since died.

NHS Tayside has now asked an independent expert to review the cases to determine whether reduced chemotherapy could have been a factor.

The health board has said it is “really sorry” to all patients and families affected, and has promised to revert to the standard dose for Docetaxal.

However, acting medical director Professor Peter Stonebridge insisted that the risk of any negative impact on health from lower doses was "very small".

The issue came to light after a pharmacist turned whistleblower last year after becoming alarmed at the lower prescriptions and discovering that an expert panel had found no evidence to support the use of lower doses of Docetaxel.

A damning report by Healthcare Improvement Scotland (HIS), published on Monday, described a "dysfunctional team environment" where nurses and pharmacists working for the board shared fears that patients were not being consulted about the lower dose but were afraid of speaking up.

The report also said NHS Tayside breast oncologists and their contemporaries at NHS Highland and Grampian could not agree on dosing levels, with Tayside doctors not willing to “endorse” using a higher dose, while Grampian and Highland doctors failed to sign off on the guidelines unless the higher dose was available.

As the guidelines were being drafted, the Tayside oncologists asked for two bullet points regarding dosing levels to be removed, without “providing the rationale” for doing so.

Politicians have called for an “urgent” public inquiry.

North East Labour MSP Jenny Marra said: “Serious questions need to be asked of the doctors and management at Ninewells.

“I was also shocked to read that there was no attempt to rectify or change dosages after the issue had been raised.

“Staff said they were in ‘lockdown’ and had to continue to give low dosages of chemotherapy. This is a serious question for NHS management as patients were being treated with low dosages while an investigation was under way.”

Shona Robison, MSP for Dundee East, was cabinet secretary for health when the issue was first raised. She instructed Healthcare Improvement Scotland to review it.

She said: “I was deeply concerned when I discovered what had happened."

The sister of Laura Gray, one of the Tayside breast cancer patients who died, fears she may have lost out on precious extra time with her children.

Ms Gray, a mother-of-two from Lochee, Dundee, was just 28 when she died after battling the disease for two years.

Her sister, Robyn, said: “We want to know if this contributed to her death.

“I know without doubt if Laura had been given the chance of a greater dose she would have taken it. She would have done anything to be with her girls for longer.”

Breast cancer survivor Martine Sinclair, 53, from Perth, said she was disappointed at not being informed and initially feared it could impact on her recovery.

She said: “My experience with nurses and GPs in Tayside has been impressive.

“My disappointment really is if at any point NHS Tayside thought a lower dose was appropriate, then I should have still been informed.

“I’d rather have suffered a little bit more with the appropriate dose than have the effects lessened. Of course I might have received the proper dose, but I won’t know until I see the oncologist. It’s a worry and will be until I receive the letter. Four days is a long time to see if you received the right dosage.”

A spokesperson for NHS Tayside said, “As part of our response to the HIS report which was published on Monday, NHS Tayside asked an independent expert to review the breast cancer chemotherapy treatment of 14 patients who have died.

"These patients received breast cancer chemotherapy during the time period 1 December 2016 until 31 March 2019.

"The findings will be shared with the families.”

Professor Peter Stonebridge, acting medical director at NHS Tayside, said:“We have written to all affected patients who received chemotherapy as part of their breast cancer care from December 1 2016 and will be offering them a clinic appointment with an oncologist.

“We understand that patients may be feeling worried at this time and we are really sorry for that.

“The independent expert panel which reviewed the HIS report to understand any potential impact on Tayside patients arising from the different approach to chemotherapy treatment said that the risk of any negative impact on the health of anyone treated for breast cancer from December 1 2016 was very small.

“We want patients to know that we are taking this issue extremely seriously and putting in place all the necessary changes to ensure we provide a high quality breast cancer service in Tayside.”

Further information is available from the Immediate Review Group report and the Independent Advisory Group report of August 2019