Written Answers. - Mammographic Screening.
Thomas P. Broughan
Question:
186
Mr. Broughan
asked the
Minister for Health
the number of women who had mastectomies in the years 1992 and 1993; the number of those who were under 40 years of age; if, in view of the fact that breast cancer is the second most common cause of death for young Irishwomen between the years of 25 and 34, he will initiate a national mammographic screening programme for all women.
Information on procedures carried out in publicly-funded hospitals is collected through the Hospital In-Patient Enquiry (HIPE). Coverage for 1992 was approximately 75 per cent of total discharges. Returns received so far for 1993 give approximately 68 per cent of total discharges. Numbers of mastectomies recorded by HIPE for 1992 and 1993 are given below subdivided by age group.
Number of Mastectomies 1992 and 1993
|
Year
|
Under 40
|
40 and Over
|
Total
|
|
1992
|
65
|
491
|
556
|
|
1993
|
59
|
500
|
559
|
Source: Hospital In-Patient Enquiry (HIPE).
The provisional figures show that six women aged between 25 and 34 years died from breast cancer in 1992.
As the causes of breast cancer remain to be clearly established, emphasis is placed on early detection at the preinvasive stage, through mammography, and consequent early treatment.
Mammography in Ireland is used largely as a diagnostic tool for symptomatic or worried women. Diagnostic mammography services are now provided at 17 hospitals throughout the country and expertise has been growing in all aspects of the early detection of breast cancer and its treatment. Mammography is available to all women on referral from their general practitioners or through the local breast clinic.
Mammography screening involves the carrying out of mammography on a mass population basis to detect those women with unrecognised breast cancer. There has been considerable debate and discussion regarding the effectiveness of mammography screening in reducing mortality from breast cancer. However, there is general agreement that mammography screening programmes are not effective in reducing mortality in younger women. For this reason mammography screening programmes tend to be directed at women aged 50 years and over.
Studies have been carried out abroad which suggest that well organised screening programmes can reduce deaths from breast cancer in women aged 50 years and over by 25-30 per cent among the screened population. As indicated earlier, however, medical opinion is divided on the value of mammography as a mass population screening tool and some doctors consider it to be ineffective. As I have said on previous occasions, it is essential to establish whether positive results can be achieved in Ireland and also to determine how they might be achieved.
My Department is supporting a major mammographic breast screening programme currently under way at the Mater Foundation. This programme — the Eccles Breast Screening Programme — is part of a network of pilot schemes on breast cancer screening being carried out within the European Union. The Eccles Breast Screening Programme is being carried out in a defined catchment area, North Dublin and Cavan-Monaghan. All women in the catchment area aged between 50-64 years are eligible to attend for screening. The age group to be screened complies with EU criteria.
The programme is the first study of its kind undertaken in this country. Decisions on the national policy to be followed in this matter will be influenced by the results of the pilot study.
