Madam, – Like many other patients with breast cancer, the poorer outcomes in Ireland with respect to other western countries are a considerable source of anxiety and distress to us and we support Christine Murphy Whyte’s arguments in favour of breast screening (August 19th).
However, we believe the advantages of early detection through mammography and/or ultrasound should not be confined to the over-50s age group.
More than 600 cases of breast cancer occur in women under 50 in Ireland annually. Latest figures show 75 per cent of these, or 455 cases, occurred in the 40-49 year age group in 2007. Most of these women were diagnosed by finding breast lumps.
Unfortunately, presenting with symptoms of breast cancer like this generally means more advanced cancers, with all the attendant misery of extensive treatment and side-effects and also poorer overall survival outcomes. The diagnosis of breast cancer has a devastating impact at any age, but particularly so for younger women at the peak of their careers, with mortgages and younger children. In addition, breast cancer is the leading cause of death in the age group 35-50 years in Ireland.
In Ireland, the breast screening (BreastCheck) policy of advertising creates the erroneous and false impression that breast cancer does not exist in younger women and that they are not suitable for mammography. In fact, countries with the best outcomes such as the US, British Columbia and Australia, in addition to providing screening to older women, also give the choice to women from 40 years to screen themselves.
The risk of breast cancer rises with age and are 1: 220 in the 30s age group, 1:50 in the 40s and 1:35 over 50 (National Cancer Institute, US). The big rise in cancer begins in a woman’s fourth decade. The American Cancer Society continues to recommend that a woman from the age of 40 should have an annual mammogram. We would urge GPs, consultants and other medical personnel to be aware of these risks and to discuss the option of screening mammography with younger women.
Mammography is not a perfect test and there are risks associated with it but it remains the best test for diagnosing early breast cancer in any age group.
Breast cancer found in its earliest stages can be completely curable with minimal treatment and younger women should know that they can avail of annual screening mammograms in many private hospitals from age 35 years within the State. A cancer charity also provides this screening in the North.
As representatives for two support groups for women with breast cancer, we actively encourage younger women to use this information and request regular screening.
We urge public health policy makers to give this choice to younger women on a national scale to reduce the misery and burden of this epidemic disease. – Yours, etc,