Breast cancer reassessment may swamp system - claim

THE REASSESSMENT of women who had attended hospital clinics with symptomatic breast disease in the last two years could swamp…

THE REASSESSMENT of women who had attended hospital clinics with symptomatic breast disease in the last two years could swamp the health system, cancer specialists have warned.

Senior medical sources have told The Irish Timesthat up to 8,000 women may need to be seen in specialist breast clinics in a short period of time, and that this would delay the assessment of women who find breast lumps or experience new breast symptoms in the coming weeks.

However, the director of the National Cancer Control Programme, Prof Tom Keane, said women should not be concerned, as separate waiting lists will operate for those women seeking reassessment and other patients presenting with new symptoms. He expected a short-term blip in the numbers of women seeking reassurance over a period of two weeks or so.

"If I am wrong, and if there are thousands of women , then we will review the situation" he said.

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The specialists' concerns have arisen following the announcement earlier this week by Minister for Health Mary Harney that women who had been told they do not have a diagnosis of breast cancer in the last two years, but who remain concerned, should contact their GP, who would refer them to a designated cancer centre for further assessment if necessary.

However, a number of surgeons, radiologists and oncologists have said that if 10 per cent of women who attended hospital symptomatic breast clinics in the past two years, and who were diagnosed as not having breast cancer, seek a second opinion in one of the designated specialist centres, the system will be unable to cope.

Based on a calculation that some 40,000 women present with breast symptoms that require hospital assessment each year, indicating 80,000 women were seen in the last two years, the experts say that if 10 per cent of these women seek reassurance, then 8,000 patients will require reassessment.

The specialists believe most of these women will require further mammography or ultrasound. "With a shortage of breast radiologists and an already stretched system, this could be a disaster," a source said. Another pointed out that 8,000 patients represented the entire yearly workload of two cancer centres.

Prof Keane acknowledged the system had limited capacity but said that "on a short-term basis, we can run extra clinics". He said both he and Prof Arnold Hill, the national adviser on surgical oncology, believe the numbers requiring hospital assessment will be manageable. The director of the cancer control programme said that, as of yesterday afternoon, less than 10 referrals had been made to the dedicated referral line set up for GPs seeking to have women reassessed.

Sources close to the Irish College of General Practitioners said while some women had attended GPs seeking information on their original diagnosis, there had been no surge in patients looking for further investigation or referral.