Absence of BreastCheck blamed for high mastectomy rate

MORE than half of women with breast cancer in the west are having to undergo a mastectomy, compared to one-fifth of women in Dublin who have the disease, new figures reveal.

Women in the west and the south of the country currently have no access to BreastCheck, the national breast screening service, expected to available in these regions in mid-2007.

Cancer specialists estimate that 65 women are dying each year in the west and south because their cancers are discovered too late.

Professor Michael Kerin, who directed the BreastCheck service at the Mater Hospital in Dublin before relocating to University College Hospital Galway, blamed the absence of the long-awaited screening programme for the significantly higher proportion of mastectomies for women in the west.

“When I worked in the Mater, 78% of the people I worked on had conservative breast surgery and only 22% had mastectomy.

“Of the first 260 breast cancers that I have operated on in Galway, 140 have had mastectomy - that’s more than 50%,” he said in an interview.

Prof Kerin pointed out that the lack of free screening meant many women in the west were presenting with advanced disease more often.

“By the time a lump occurs, the tumour has grown to a size that is two centimetres or more.”

Prof Kerin said women presenting late with the disease were more likely to have mutilating surgery, experience post-operative problems and require more aggressive follow-up treatments.

He said more conservative breast surgery could be done on a day case or one-night hospital stay basis.

Prof Kerin expects to pick up 170 cancers every year when breast screening is in place in the west.

Breast cancer is one of the most common cancers among women in Ireland.

Approximately 1,600 cases are diagnosed each year. BreastCheck is confident it can roll out its programme to the south and the west from 2007 onwards, bringing screening to an additional 130,000 women in the 50-64 age range.

Since the national screening programme started in February 2000, 1,574 cancers were detected.

BreastCheck calls women every two years for screening while the British National Health Service calls women every three years.

The shorter interval ensures better survival rates because a mammogram can detect breast cancer up to 18 months before there are any symptoms of the disease.

Meanwhile, BreastCheck chief executive Tony O’Brien has confirmed it hopes to bring forward the launch date of a breast screening programme in the south and west. It had been planned that the Galway and Cork-based services would not open until late 2007 but it’s now understood they could be in place by the late summer, subject to the receipt of planning approval.