Malcolm Noonan (Green Party)

Cuirim fáilte roimh an Aire. The Minister is very welcome and I welcome this debate.

The points have been well made in respect of breast density. I bring this on behalf of a friend of mine who has campaigned on this issue. The main points she asked me to mention are that women with dense breasts are at a higher risk of getting breast cancer. Also, they do not know whether they have dense breasts. When the BreastCheck service and hospitals conduct mammograms, the radiologist reporting on the mammograms knows but the information is currently not reported to the woman, as it is in most other countries. This fact has been highlighted by other Senators here this evening.

Another aspect is that women diagnosed with ductal or lobular breast cancer should have an annual MRI as standard because the mammogram does not always diagnose lobular breast cancer. My friend also asked me to mention a fact about the annual mammogram. Her last ductal breast cancer was in 2008 and her mammogram in 2022 reported her as being clear. A year later, however, her mammogram diagnosed extensive lobular breast cancer, with 55 of 59 auxiliary glands positive for cancer cells. A woman's breast density can be assessed by a radiologist's reading of her mammogram images. Breast density is a highly visible radiological finding. There are four levels or categories of breast density. Category C is heterogeneously dense and category D means extremely dense, and these categories are considered to be dense breasts.

It has previously been reported that BreastCheck radiologists are not willing to make a subjective decision about whether a woman's breast tissue is dense. Therefore, there is no standardised reporting. Women who have dense breasts have no other way of knowing unless the radiologist reports it. Currently, women with dense breasts are left in the dark about their increased risk of developing breast cancer and radiologists, in turn, turn a blind eye to the issue - an additional risk of masking. In view of this and to adjudicate, it is important to point out that software is available. It works well in other breast screen jurisdictions along with their existing 2D mammogram equipment screening in hospital settings. It is known to be accurate and matches well with the subjective density measurement in terms of predicting risk and masking. Again, like other Members, I ask the Minister to introduce standardised mandatory breast density reporting for all women who have mammograms in Ireland.