Pauline Tully (Cavan-Monaghan, Sinn Fein) | Oireachtas source

For the last few years I have requested Cavan County Council to light the courthouse in pink for the month of October to highlight breast cancer awareness. The council has always obliged and I am thankful it for that. It was not my initiative but that of a woman with stage-four breast cancer. She is an excellent advocate for breast cancer awareness and is very focused on making women aware of the signs of breast cancer and of the importance of checking their breasts regularly. She has spent years undergoing treatment and is still doing so but is always good humoured, positive and thinking of others. I want to pay tribute to her for all the work that she does.

She has also advocated for the extension of BreastCheck and feels strongly that it should be expanded to those aged 40 and over. She points out that if this had been the case, she would have been diagnosed earlier and would not have had to go through all of the treatment she has endured. There are also potentially major savings to the State from early diagnoses and I hope that additional investment in screening programmes will be provided. Women must be screened and if the HSE is not willing to provide mammograms, it could provide ultrasounds which can be just as effective. From the age of 40 onwards hormonal changes are happening in the body and it vitally important that women are screened while these changes are happening. A high volume of breast cancer cases are estrogen driven and a mammogram will pick this up. For women aged 25 to 40, an ultrasound is effective and non-invasive. For women over 69, an ultrasound can pick up changes in the breast tissue. According to Breast Cancer Ireland nearly one quarter or 23% of women diagnosed with breast cancer are between the ages of 20 and 50 while approximately 36% of women diagnosed with breast cancer are over the age of 70. In that context, all women need to be checked and screened regularly. GPs could play a bigger role in this area. Some GPs, no matter what one attends for, will offer to do a breast check. It would be good for all GPs to consider doing that if possible.

I am also concerned about a potentially high number of undiagnosed cases due to BreastCheck being suspended during Covid. It is alarming that disruptions to cancer screening programmes caused by the pandemic may lead to people presenting for treatment at much later stages of the disease. A year has been lost as a result of Covid-19 and that will take years to address. The pandemic and the HSE cyberattack have both had a negative impact on screening and, indeed, are still having an impact. That said, capacity issues have existed for a number of years so it is not accurate to blame all delays on Covid or the cyberattack.

A major effort must be made to make screening accessible to all women. I have spoken to many disabled women who often find that when they present for screening they cannot be accommodated and have to wait for another appointment. Nobody should have to wait. There is also concern about the lack of medical oncologists. I understand that there are only 41 such specialists when it is estimated that 100 will be needed by 2028. There are also shortages of radiation and surgical oncologists and haematologists. Serious efforts must be made to address this problem.

I also wish to acknowledge that breast cancer is not just a women's problem. Men are also affected, with one in every 200 cases of breast cancer in a man. This form of cancer can effect one in 1,000 men. I understand that cannabis use is a common cause of breast cancer in men and awareness of this must be increased.

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