Nessa Cosgrove (Labour)

The Minister of State, Deputy Murnane O'Connor, is very welcome. Imagine going to the GP for a routine check-up, the equivalent of a national car test, NCT, when you reach a milestone birthday. The GP measures and weighs you, takes your blood pressure and temperature and listens to your pulse. It is, I assume, a thorough examination. The GP reassures you. Everything is clear and you appear to be perfectly healthy. If you keep living an active and balanced lifestyle, you can expect to live to a healthy old age.

Six months later, you receive the devastating news that you have a 7 cm growth. It is stage 3 invasive cancer. It was there at the time of your check-up but the GP did not stop it because it was as if you were wearing a coat that prevented them from carrying out a proper examination. This is what happened to Siobhán Freeney. She went for a routine mammogram in the summer of 2015. By Christmas, she had been diagnosed with a stage 3 invasive lobular carcinoma. It is a type of breast cancer that starts as a growth of cells in the breast's milk-producing glands.

Now imagine that the same thing happens to the person you love and depend on more than anyone else in the world, namely, your mother. That is what happened to Martha Lovett Cullen, whose mother, Marian, received even worse news. Twelve months after her clear mammogram in 2020, she received a diagnosis of terminal stage 4 metastatic breast cancer. How could this happen to two different women in different parts of the country seven years apart? They both had significant quantities of dense, non-fatty tissue within their breasts. This dense breast tissue, which is fibrous and muscular, makes it difficult for a standard mammogram to see potential growths or tumours. Breast density levels are impossible to assess visually or by touch. They can, however, be measured during a standard mammogram. The radiographer carrying out the mammogram should be able to note the presence of dense breast tissue and advise women undergoing a breast check that further investigation through an ultrasound or MRI scan will be required to confirm any seemingly clear results. I am not being alarmist, but women need to be aware that a clear mammogram result does not mean they are clear of cancer. It means that no cancer is visible. Absence of evidence is not the same as evidence of absence. Siobhán's treatment was successful. She beat the cancer and became a fierce advocate, highlighting the issue of breast density. Marian was not so lucky. In September 2024, the cancer took her life. Her daughter, Martha, found a purpose within her grief and just like her mother, Siobhán, she harnessed her fierce determination to ensure that Irish women were aware of the issue. This is how I, a woman who will shortly be attending my first mammogram when I turn 50 in September, first heard about breast density. If I had not been aware of it, I would have accepted a clear result as just that - clear. I know from the reaction of several of my senatorial colleagues and friends that when I raised this issue a month ago, it was the first time that many of us had heard of this also.

Breast density is not unusual. In fact, it is virtually the norm. It is estimated that between 43% and 50% of women have dense breast tissue. Siobhán, Martha and I hope that, as women, the Minister of State and the Minister will appreciate the urgency and necessity of this. It is already done in every state in America and in Australia, Canada and several of our European neighbours. This is information that is easily derived by the radiologist at the time of a mammogram and we ask that this be passed on to the women at the time of their screening. Clearly, women need to know whether they have dense breast tissue. They also need to know the potential consequences of that information. I implore the Minister, within the lifetime of the Seanad, to introduce a Bill to ensure that all women are clearly informed whether they have non-dense or dense breast tissue, after a mammogram. Clear guidance should also be provided on what their breast density means and on any additional screening options, such as an MRI or ultrasound. GPs should receive this information so that they can properly advise their patients.