BreastCheck missing targets is a worrying step backwards

If a woman is referred to a diagnostic clinic, she should be scanned that day. Every week matters, and yet we are asking women to wait half a year while the disease potentially advances, writes Fianna Fáil senator Teresa Costello

Fri, 29 Aug, 2025 - 00:51

Teresa Costello

“You have cancer.” Three words that stop you in your tracks and make you face your own mortality.

I was 36 when I found a lump in my breast while taking a shower. I wasn’t checking myself; I never did. I thought I was invincible. Breast cancer never crossed my mind.

I acted quickly and went to my GP who referred me to St James Hospital that day. I attended alone as I didn't think the news would be bad.

I underwent a physical examination, followed swiftly by a mammogram, ultra-scan and biopsy. The moment I removed my top, the medics didn’t hesitate. There was no doubt in their minds — I had cancer.

The signs were unmistakable a deep indentation in my breast, dimpling of the skin and not one, but three tumours. Looking back, I’d missed nearly all of them. All but one. From that moment, my life became a whirlwind.

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I was told to bring someone with me next time because I was to receive confirmation that I had cancer. I brought my cousin and the consultant confirmed I had breast cancer. He explained it “had a personality” so I would need to start chemo as soon as possible.

Two weeks later, I started treatment. There was no time to freeze my eggs. I had to be grateful for the little boy I already had who turned six the day before my first chemotherapy session.

The hardest part was telling my family. Watching the heartbreak spread across their faces was almost as devastating as hearing the diagnosis myself. For the first time, I had to face the very real possibility that I might not survive to see my son grow up.

My treatment included chemotherapy, radiation and a mastectomy with lymph node removal followed by a decade on Tamoxifen. This part of the whirlwind was relentless.

My body was flooded with medication that brought their own cache of side-effects. I lost my hair, I was catapulted into menopause, my eyes were dry, I was plagued by blisters in my mouth, weak nails, I lost teeth. I gladly accepted all of this if it meant I would make it to the other side.

I was one of the lucky ones. I came out the other side and built a happy and full life.

Cancer changed my perspective and gave me a greater appreciation of life, a deeper sense of gratitude and a passion for healthcare that has shaped my advocacy work.

That is why I was devasted this week to read reports about BreastCheck missing its screening targets. Alongside my colleague, Deputy Erin McGreehan, I made a submission to the National Screening Advisory Committee calling for the expansion of the BreastCheck programme to women from the age of 40. Currently, screening is only available from age 50-69 but you may be 52 when you receive your first appointment.

A third of all breast cancers diagnosed in Ireland are detected through BreastCheck. Screening is for women who appear healthy — those who do not yet have symptoms — and early detection offers the best chance of survival.

When women don’t show up for their appointments they may be missing their opportunity to catch cancer before it spreads. We urgently need to reduce “no-shows”, but that is a matter of personal responsibility.

However, my biggest concern is not just with screening, but with the diagnostic pathway for younger women. When I was referred to a diagnostic breast clinic, I was scanned the same day. Today, I hear of young women being sent home with the promise of appointment for a scan that can take up to six months to receive.

Breast cancer in younger women tends to be more aggressive. If a woman is referred to a diagnostic clinic, she should be scanned that day. If no cancer is found, she leaves with peace of mind. If cancer is present, treatment can begin immediately. Every week matters, and yet we are asking women to wait half a year while the disease potentially advances.

Generally breast cancer treatment in Ireland is very good with survival rates improving. I feel it's important that people know the differences between screening and diagnostic scanning as sometimes it's not clearly explained when discussed.

Teresa Costello: 'Cancer changed my perspective and gave me a greater appreciation of life, a deeper sense of gratitude and a passion for healthcare that has shaped my advocacy work.' Photo: Fianna Fáil

I would urge any woman reading this not to make the mistake I did. Check your breasts regularly. Know your normal. Attend your BreastCheck appointment when invited. If something feels wrong, insist on answers.

Cancer changes everything. It breaks you open, strips away illusions of invincibility, and forces you to value every single day. I survived, but many women don’t. That is why I will continue to raise this issue in the Seanad and beyond — because earlier detection, faster diagnosis, and more personal responsibility will save lives.

If you take anything from my story, let it be this: check your breasts, attend your screenings, and take ownership of your breast health. It might just save your life.