Erin McGreehan (Fianna Fail) | Oireachtas source

I welcome the Minister of State, Deputy Feighan. I welcome the opportunity to speak on this important issue that involves saving lives. It is of utmost importance to many women, men and families all round the country. I have worked with my Fianna Fáil colleague, Councillor Teresa Costello, in South Dublin County Council on many breast care issues. This is another issue that she and I work on regularly. I ask for an update from the Department of Health on the waiting list for preventive mastectomies and about the service at St. James' Hospital in particular. This is a life-saving service. There is excess demand for it, so it is important that the service is expanded without delay. People with a higher risk of cancer due to their family history have to wait far too long for genetic testing in the first place. There are long, stressful waiting times for preventive mastectomies due to overstretched services and due to delays caused by Covid.

Inherited faulty genes play a major role in 5% to 10% of all cancers. Genetic testing is an important tool in aiding understanding of an individual's risk of certain types of cancers, including breast, bowel and ovarian cancers. Not knowing whether their family history of cancer puts them at higher risk of developing the disease can be a cause of great anxiety and stress for people. Having early access to genetic testing can provide options for that preventive treatment and reduce the possibility of ever receiving a cancer diagnosis at all. A growing number of women are taking the difficult decision of having double mastectomies and then reconstruction or of having their ovaries removed to reduce the risk.

There are major delays at many of our public hospitals. As a genetically inherited alteration passes through those family lines, the breast cancer gene, BRCA, significantly increases a person's risk of developing cancer. A mastectomy can reduce the chances of people who carry those BRCA genes developing cancer by 90% to 95%. That is an astronomical figure.

A recent survey by the Irish Cancer Society found that one in seven people have been waiting for more than a year for tests, with some waiting for more than two years for risk-reducing procedures. I highlight issues at St. James's Hospital in particular. In 2018, the family history service was curtailed due to excessive demand. I know that urgent and high-risk patients continue to be seen at the family risk clinic, but there is only one consultant plastic surgeon who supports the breast care service. There is increasing demand for the symptomatic breast service, diagnosed cancer, surgical treatment and reconstruction. They are being targeted but it is not enough. I understand a business case is being developed, but it is a crass way of describing an important preventive measure that is designed to save people's lives.