Professor Ann O'Doherty:

It is what we do. Two independent readers look at it. We look at our misses and our triumphs, as some of the cancers we pick up are at the very edge of perception. It is an absolute and open learning environment in screening. The biggest downside is that we do not pick up all the breast cancers. I work as the lead clinician in symptomatic services at St. Vincent's University Hospital. I do not go in every morning with an expectation I will miss cancers because I have ultrasound and other tests available. Unfortunately, screening mammography is an inferior test. As clinicians we must face it that we will let down women. Not only are we going to let down women but we are going to let down their families as well. It is a real downside to what we do.

When we see cancers that should have been picked up - let me tell members that there are some cases where we ask ourselves how they were missed - the only way to survive knowing a disservice has been done to the woman in question or her family is to think positively about the pick-ups we have made. We are the most transparent, quality assured, introspective group of people members will have met. We are informed by the symptomatic service of an interval cancer. I can remember at least ten times in my life asking myself how we missed a cancer but when we got the symptomatic mammogram, the cancer may have been in a completely different place. We are busy and self-critical. I assure members that we are the most neurotic, self-absorbed group of people running the breast cancer screening service in this country. Unfortunately, even with the best will in the world, we will miss things, including some obvious ones in hindsight.