Dáil Éireann debate -
Tuesday, 19 Apr 1994

Vol. 441 No. 5

Adjournment Debate. - Screening for Breast Cancer.

Miss Quill

I thank the Ceann Comhairle for allowing me to raise this matter of some importance on the Adjournment and I thank the Minister for being present in the House to reply. I appeal to him to provide as a matter of urgency a State-funded screening service for all women in the high risk category group for breast cancer.

Breast cancer is one of the major unsolved problems in medicine today and is by far the most common form of cancer among women. The average Irish woman has a one in 11 chance of developing breast cancer during her lifetime. Breast cancer is the second most common cause of death among women aged between 25-34 years and is the most common cause of death among middle aged women. More than half of deaths among women aged between 50-64 years are caused by breast cancer. Last year 660 women died from breast cancer. This is the highest figure in any country in the EU.

In a well researched speech last week, the European Social Affairs Commissioner, Mr. Pádraig Flynn, predicted that deaths from cancer would continue to rise by the dramatic figure of 15 per cent over the next number of years. These statistics give a clear idea of the scale of the problem. The effects of this problem and the suffering and anguish it inflicts on women cannot be quantified. Neither is it easy to quantify the effect the death of a young mother can have on her young children. The fact that this problem cannot be quantified does not mean it can be ignored. Modern research demonstrates categorically that early detection of breast cancer can save many lives and lead to a substantial reduction in the number of deaths from breast cancer. Scientific evidence proves that the survival prospects of women in the 50-64 age group can be improved by as much as 33 per cent if a national screening programme is in place.

I am, therefore, calling on the Minister not to ignore the reality of those figures and to put in place as a matter of urgency a national screening service. This would be a substantial investment in ensuring good health among women in particular and society in general. I would also regard it as another essential step forward in tackling the scourge of breast cancer. Taken in conjunction with the research into finding a cure for breast cancer, a State-funded screening service would enable us to say we were nearing the stage when a cure for breast cancer would be within our reach.

Mr. Howlin

I thank Deputy Quill for raising this very important matter. I share the concern expressed by her and many organisations, particularly women's organisations, and most notably the Irish Countrywomen's Association, about the high incidence of breast cancer among Irish women and the need to put in place mechanisms which will reduce the high incidence of this problem.

The causes of breast cancer remain to be clearly identified and emphasis is, therefore, placed on early detection at the preinvasive stage, through mammography and consequent early treatment. At present mammography is used largely as a diagnostic tool for symptomatic or worried women on referral by their general practitioner, consultant or through the local breast clinic. There are now diagnostic mammography units at 17 hospitals and expertise has been growing in all aspects of the early detection of breast cancer and its treatment.

Mammography screening involves the carrying out of mammography on a mass population basis to detect breast cancer in non-symptomatic women. Mammography screening programmes tend to be directed at women aged between 50-64 years. There is general agreement that mammography screening programmes are not effective in reducing mortality in younger women.

The United Kingdom and the Netherlands are the only two countries in the European Union which have organised national mammography screening programmes for women aged between 50-64 years. However, there is considerable debate and discussion internationally regarding the effectiveness of mammography screening programmes in reducing mortality from breast cancer. Before proceeding with a national screening programme for women aged between 50-64 years, it is imperative that the benefits of mammography screening, in terms of achieving a reduction in mortality, are carefully and fully assessed.

For these reasons, my Department is supporting a major mammography breast screening programme, the Eccles Breast Screening Programme, currently underway at the Mater Foundation. This programme is one of a network of pilot schemes which are at present underway in seven countries within the European Union. The other countries are Belgium, France, Spain, Portugal, Greece and Italy. The Irish pilot programme covers a defined catchment area, North Dublin and Cavan-Monaghan, representing both urban and rural populations. All women in the catchment area aged between 50-64 years are eligible to attend. Screening is provided free of charge to women taking part in the programme.

The objectives of the Eccles Breast Screening Programme are: to evaluate the impact of mammographic screening on mortality from breast cancer among Irish women; to document compliance with a breast screening programme in Irish women and to compare the specificity, sensitivity and predictive value of the mammography programme with that reported internationally.

The second round of screening is expected to be concluded by the end of 1994. The Eccles Breast Screening Programme is the first study of its kind undertaken in Ireland. National policy to be followed in this area will be influenced by an evaluation of the results of the pilot scheme when these become available.

The Dáil adjourned at 9.10 p.m. until 10.30 a.m. on Wednesday, 20 April 1994.