Professor Ann O'Doherty:

The most important aspect of any screening programme is to do no harm. We made the difficult decision to suspend screening because many of our women go up to the age of 69. It is a very close contact examination so we suspended screening very reluctantly. That was the right decision at that time. We also had, at the time, approximately 500 women with screen-detected abnormalities so we set about doing that. We are conscious that we have a lot of ground to make up. It is the last thing in the world that I would want to do. I have spent my whole professional life advocating screening and it is the last thing I would want to do.

If we screen 1,000 women, we will pick up seven cancers. If we look after 1,000 women with specifically urgent symptoms we will pick up 100 cancers. We had a situation where we did not have the ability to do everything. The hospitals were being protected for the big surge. It was a challenging time and there was a lot of fear. I want to congratulate all our staff for helping us to deliver the service at all stages during this time. We have been working to look after women with symptoms and that is the priority. We must maximise our efforts. We are in the middle of a pandemic. Our ability to get back to screening normally is limited until we get to a situation where we do not need to have 2 m social distancing. It is not that we do not want to, but that is the reality and we will do everything in our power.

There is, however, a whole area of work. The European Society of Breast Imaging has given us guidelines on what to prioritise in the Covid-19 situation. We have been following exactly that guideline and the lowest priority at the moment is screening healthy women. We have women with a family history who have an 80% lifetime risk of breast cancer. They are in the hospitals and we are screening them at the moment. We are screening women with previous breast cancers. They have a much higher incidence. We are using our resources to the best of our ability in a very challenging environment.