Teresa Costello (Fianna Fail)

I thank the Minister of State for being here today. October is breast cancer awareness month so it is very timely that I am raising this issue today, the same day that I will attend my annual mammogram. I will most certainly be repeating myself today as I have spoken previously about the delays in scanning in symptomatic breast clinics. I will continue to repeat myself because the situation really concerns me.

I am speaking both as a breast cancer survivor and as the founder of one of Ireland's largest online support communities for people affected by breast cancer. Every day I hear of the challenges and fears people face, from the moment they have a concern to when, if they are unfortunate, they receive a diagnosis. Breast cancer cases are rising, with almost 3,600 women diagnosed in Ireland each year. Approximately 23% of them are under 49 and 37% are aged between 50 and 64, while 39% are over 65 years of age. Since the 1990s, breast cancer diagnoses have increased by 120%. Survival rates have improved. The five-year survival rates are now around 85% compared with 70% two decades ago. For younger women, cancers tend to be more aggressive, making early detection critical. For those with metastatic disease, survival is far lower. This is why timely access to diagnostics and equitable care across all regions must remain a national priority.

I welcome the updated GP referral guidelines from 2023 because GPs are often the first step in saving lives. I know because I have my own GP, Dr. Barry Quinn, to thank for my timely referral. However, guidelines only matter if the system delivers. Key performance indicators state that urgent referrals should be seen within ten working days and non-urgent referrals within 12 weeks. In 2024, compliance nationally was 76% but this varied hugely by hospital. It was as low as 29% in some and as high as 91% in others. That is an unacceptable gap. Scans for new patients should take place within 12 weeks of a consultant's assessment. Compliance with this was reported to be 92% but here is the real problem: many younger women who see a consultant are examined but not scanned. They are then sent away to wait for another three months for imaging, with some ending up waiting six months or more for a full assessment. For aggressive cancers, that delay could mean the difference between early detection and a late-stage diagnosis.

When I was diagnosed in 2013 I received a triple assessment on the day of my first appointment and my chemotherapy was organised almost immediately. I was at stage three and swift action saved my life. I must ask again, as I have done previously, if the process or policy has changed? If so, why has it changed? What is the point of the first appointment if no scan takes place? Most women attending breast clinics will require a scan so why not perform it that day? Stories from younger women are devastating. The Too Young to be Heard campaign highlights how young women feel that they are being dismissed because of their age and, when they finally reach a clinic, delays continue. They are not asking for special treatment but for timely, appropriate care. Today I am asking for a clear commitment that symptomatic breast clinics will be resourced to carry out diagnostic scans at the first appointment, ensuring that younger women will no longer feel dismissed or be left waiting months for a scan. I speak from experience when I say that breast cancer treatment in Ireland is very good. The outcome for many patients is positive but the delay in diagnosing younger women risks costing those women their lives or costing them precious time.