Madam, – Muiris Houston writes that “Breast screen benefits need to be revisited” (HEALTHplus, October 19th). Currently all high quality medical research into breast cancer screening clearly shows an increased detection of cancer and improved survival in patients screened. What has been questioned is the amount of the improved survival which can be directly apportioned to screening; in recent years the overall treatment of breast cancer has improved dramatically.
Research into breast cancer in Ireland has shown that patients diagnosed and treated within the Breastcheck programme have a better prognosis than patients diagnosed within symptomatic breast disease, because screening detects early and potentially curable disease. It is only in the past three years that we have a truly national breast screening programme, with the opening of units in Cork and Galway, and we should realise the benefits of this in the next 10 years, with the continued improvement in breast cancer survival for Irish women.
If we measure outcome from breast cancer screening as a national average of breast cancer survival, the screening process can only work if it is offered on a national level.
Unfortunately much of the negative debate on screening has come from non-clinical epidemiologists looking at numeric estimates; what cannot be easily measured is the profoundly positive impact of Breastcheck. My own experience of patients’ views towards our screening programme is overwhelmingly positive. Cancer screening should be regarded as a moral responsibility, in times of economic crisis the national cancer screening programme should be exemplified as a model for good use of public money to the national benefit. – Yours, etc,