I propose to take Questions Nos. 138 and 139 together.
In parallel with the Rapid Access Clinic for Symptomatic Breast Disease in St James's Hospital, a Familial Breast Cancer Risk Assessment Service has evolved to provide a clinical service to women who are considered to be at higher than average risk of developing cancer in their lifetime. Due to increased referral rates to the symptomatic breast disease clinic, as well as to the 'family risk' clinic, the hospital is currently prioritising the symptomatic patients to ensure that a quality, timely and sustainable service is available to them. This has resulted in the suspension of the family risk service, other than for very high risk patients.
During 2018, one of the hospital's two mammography machines was replaced and a third machine has been installed. Capacity for mammography has been a major part of the challenge in meeting demand for breast services in St James's. It is expected that the Familial Breast Cancer Risk Assessment Service in St James's will be restored in the next two months.
While there is no national programme for screening for high risk cancer genes, patients found to carry a cancer predisposition gene such as BRCA1 or BRCA2 are followed up at all designated cancer centres.