Two Salmon Arm women are among those waiting to see if their breast cancer test results were accurate.

Their tests are among 58 biopsies performed between 2005 and 2006 at Kelowna General Hospital that are undergoing an external review.

The estrogen receptor tests were previously subject to an internal review by Interior Health after a former IHA pathologist, Dr. Kirk Ready, publicly raised questions about the tests in 2007.

Dr. Robert Halpenny, senior medical director at Interior Health says the internal review failed to find evidence that the biopsies were misread.

The women were all correctly diagnosed with breast cancer, he says. In question is whether estrogen receptor testing was accurate.

Some tumours feed on estrogen while others do not, explains Halpenny.

In the case where the tumour is ER sensitive, a medication is given to block the estrogen. If the tumour is ER negative, the drug simply does not work and is not included in the treatment regime.

While reluctantly agreeing that neglecting to give ER-positive patients the blocking drug could negatively affect their health outcomes, Halpenny says the change from being ER positive to ER negative is not like hitting a light switch, but more like a slow slide.

“We do know it’s highly unlikely that a patient will transfer from strong ER negative to strong ER positive, and the ones that are strongly ER positive are the ones for whom the drug works best.”

Halpenny says the health region decided to go to an external review now because of the recent furor over incorrect diagnoses in Newfoundland and Quebec.

Dr. Warren Bell, president of medical staff at Shuswap Lake General Hospital, says he has great respect for Ready and his “courageous stand” against the health authority.

“He struck me as a real straight arrow,” says Bell, noting he has at times been very frustrated in his own dealings with IH laboratory and had conversed with Ready. “His comment was the focus in designing the lab system was of cost-containment and not on clinical effectiveness.”

Meanwhile, Halpenny was reluctant to give an estimated time for completion of the reviews because of the detail involved in the work. He said completing the case reviews is a priority for both Interior Health and the B.C. Cancer Agency, and the organization would get through it as soon as possible.

NDP health critic Adrian Dix said the provincial government previously denied there were any problems with the testing, and had aggressively said there should be no external review. Dix said the NDP is expecting a full report on the external review, but also on why it has taken so long.

“Their response to a really serious issue has been glacial,” Dix said.

Ready went public with his concerns when he left the IHA to work in Calgary earlier this year.

Dix said the review should have happened independently of Interior Health in the first place, and that there was not enough consideration of the problems first noted by Ready.

“I think the issues he raises are serious, and I don’t think the government has acted in a manner consistent with that. We’re not talking about policy issues, we’re talking about the safety of the individuals in question.”