Professor Risteárd Ó Laoide:

As I mentioned earlier, the symptomatic breast service sees 42,000 patients each year. About 3,500 people were being referred each month, but that number has been increasing in recent weeks. We are now getting between 4,500 and 5,000 referrals each month to the symptomatic breast service. The key issue in this regard is a background of strained capacity within our system. That was recognised in 2018. The number of attendances has been progressively increasing since the initiation of the breast cancer symptomatic units. The impact of Covid-19 further decreased that capacity due to the infection prevention and control measures and in respect of our access to diagnostics. There was also impact due to the potential for staff to be redeployed because of Covid-19 and because of staff contracting Covid-19. As the Deputy recognises, then, there is a background difficulty in this respect.

Attendance has been increasing, however, as I said, to between 4,000 and 5,000 each month. Triage is central to how we deal with that increase. As urgent requirements are the most important to address, we triage our patients and about half are triaged as urgent cases. As I said earlier, 90% of those patients are then seen within four weeks and all of them within six weeks. The incidence of cancer in the urgent group is about 10%, which is a significant level. The incidence of cancer is less than 1% in the group of patients triaged as non-urgent and that is akin to the background rate of incidence of cancer in a screened population. The patients in that group are further triaged into people who may need mammography only, those who might need a clinical review and ultrasound, including the younger patients we discussed earlier, or patients who may have an initial clinical review and who are then-----