Nicole Ryan (Sinn Fein)

It is lovely to see the Minister again today. As she will know, breast cancer affects a great many women across Ireland. There is an urgent need to improve how we detect, support and treat those who are affected. Breast cancer is the most common cancer among women in Ireland and yet, according to Breast Cancer Ireland, only 19% of women who do not regularly check their breasts say they would recognise a symptom of breast cancer. That is quite alarming and tells us that we are not doing enough to educate and empower women as regards BreastCheck and breast cancer. I am mortified to admit that I only learnt how to properly check myself last year. I am 32 so I was 31 years of age. There is a demographic group of such women. I only learnt by chance. A fantastic woman from Breast Cancer Ireland named Juliette was doing workshops on checking breasts and looking for lumps in a school for any young women and men who wanted to participate. She mentioned things like rashes. I did not have a clue that a rash could be a sign of cancer. If I had not been in that school on that day, I would never have learnt that. My generation, those in our 30s, 40s and even a little bit younger, never had education like that in school. We were never taught about checking your breasts or what to look out for. If we are not looking at checking women who are younger, we need to empower them and build out the education system as to what to look out for and when to worry.

As other Senators have said, we need to talk about breast density because it is a topic that is not spoken about enough. It was first mentioned by my colleague Senator Cosgrove. Women with dense breast tissue are often at a higher risk of developing cancer but the dense tissue also makes it very hard to detect the cancer through standard mammograms. Sometimes it is like trying to find a little snowball in a snowstorm. Most women are never actually told that they have dense breasts. This is a barrier in our diagnostic process and it is costing people their lives. The lack of awareness and transparency around breast density has to be addressed. We need to ensure that women are informed about their breast density status and what it means for their risk levels and screening needs.

However, that will not be enough if access continues to be limited. As other Senators have said, the Irish Cancer Society has pointed out that marginalised groups, including Travellers, migrants, disabled people and women in poverty, face greater obstacles in accessing services. This might include transport, a language barrier or, sometimes, discrimination. These structural issues require immediate policy action for women. While BreastCheck currently sees women who are 50 to 64 and there are plans to extend this to the age of 69, we must ensure there is an extension nationally without delay. I accept the scientific caution as regards extending screening to those under 50. The risks of false positives, overdiagnosis and unnecessary treatment are real. However, when cancer is present in younger women, it often seems to be more aggressive. If this is combined with high breast density, early detection is even harder.

Our breast symptomatic services have improved. The detection rates are significant. That proves that proper investment and timely, well-resourced and accessible diagnostic care really does work. However, these services can sometimes be overstretched and women still face delays in follow-up, particularly in rural or underserved areas. I ask that we invest in a public awareness campaign for women like me who are not educated on BreastCheck, what that entails, how to check our breasts and what to look out for. This would educate all of us who are younger as to how to check our breasts, how often we need to do it and all that kind of stuff. We also need to ensure that breast cancer services are inclusive and accessible to all, especially those from under-represented communities, from a Travelling background or whatever. Symptomatic services should be expanded to ensure every woman is seen promptly and treated with the needed dignity and urgency. Breast cancer does not wait for budgets or for policies to come out. It does not discriminate but our system sometimes does. Women in Ireland deserve better. We need real change that is rooted in science, compassion and equality.