Annual Report 2006/2007: Director's Report
In 2006 BreastCheck – the National Breast Screening Programme provided free breast screening to 63,271women – the highest number of women screened by the Programme to date. The rate of overall acceptanceof invitation to screening was 78.1% of eligible women, an increase on the number of invitations accepted in 2005 and in excess of the programme target of 70%.
Of the 63,271 women screened in 2006, 1,903 were recalled for assessment. Three hundred and thirty seven of those women recalled were diagnosed with cancer, representing 5.3 cancers per 1,000 women screened, compared to 5.3 in 2005 and 6.1 in 2004. In 2006 19,527 of all women screened were new to the programme and 43,744 women had attended at leas tone previous BreastCheck appointment.
The majority of women attending for first screening are in the 50-54 age group with the acceptance rate highest in this age group. 2006 saw a fall in acceptance with increasing age at first invitation. This age-related acceptance pattern is replicated in previ-ous non-attenders. However in all age groups attending for subsequent screening the acceptance rate is almost uniformly high.
Most Women’s Charter parameter targets were met or exceeded. The proportion of women screened for a subsequent time within 27 months of a previous screen is at the highest level since subsequent screening began. A full and detailed analysis of the Programme statistics is available on this report.
Overall in 2006:
- BreastCheck screened 63,271 women – the highest number of women screened by the Programme to date
- BreastCheck performed consistently high against the commitments identified in the Women’s Charter
- The service was extended further into the NorthEast, East, Midlands and parts of the South East
- Significant advancement was made on progressing national expansion of the service into the Westand the South with screening scheduled to commence by year-end 2007.
Change in Governance
Following the establishment of the National Cance rScreening Service (NCSS) by the Minister for Health and Children in January 2007, governance of BreastCheck – the National Breast Screening Programme is now managed by the National Cancer Screening Service Board. The establishment of the NCSS followed the publication of a Strategy for Cancer Control in Ireland 2006, which advocates a comprehensive cancer control policy programme in Ireland with cancer screening managed by one organisation.
National Expansion
Since the Minister for Health and Children, MaryHarney T.D., gave her approval for the a 25m capital expansion programme, significant progress has been made. The construction of two new BreastCheck statics creening units based at the South Infirmary Victoria University Hospital in Cork and University College Hospital in Galway is nearing completion.
The BreastCheck service is a quality assured, population based screening programme that operates using multi-disciplinary teams with specialist expertise in the areas of breast screening, cancer detection and treatment. With screening in the West and the South due to commence by the end of 2007 a major recruitment drive has been undertaken and the appointment of appropriate staff is nearing completion.
Approximately 50 staff will be employed in the Westwith an additional 50 employed to provide the BreastCheck service in the South. Clinical Directorsfor both the Southern and Western areas joined BreastCheck last November and have undergoneextensive training in advance of the opening of each unit.
Consultant Radiologists, Consultant Surgeons, Consultant Histopathologists and Consultant Anaesthetists, all with a special interest in breast disease, have also been appointed. In addition, Unit Managers, Radiography Service Managers and a number ofadministration posts have been successfully filled.
Recruitment of other staff, including the necessary 38 radiographers is ongoing. BreastCheck hosted Recruitment Open Evenings in Galway and Cork in July and received over 1,000 expressions of interest a sa result.
A fleet of seven additional mobile digital screening units have been commissioned to provide screeningin broader counties. Four units will be attached to the Southern Unit serving women in Cork, Kerry, Limerick, Waterford and Tipperary S.R. and three will be attached to the Western Unit, providing screening to women in Galway, Sligo, Roscommon, Donegal, Mayo, Leitrim, Clare and Tipperary N.R.
BreastCheck is committed to achieving the radiography standards required for high quality mammographic breast screening and provides continuous training and development for its staff.
BreastImaging - The NationalRadiography Training Centre
In support of this commitment BreastCheck developed a National Radiography Training Centre to support mammography in both screening and symptomatic services. BreastImaging – the National Radiography Training Centre officially opened and welcomed its first post graduate students this year. The centre will prove vital to BreastCheck’s efforts torecruit and train the large number of radiographers and mammographers required to serve national expansion. All Breast Imaging students will be trainedusing state of the art digital mammography equipment, similar to the equipment used at BreastCheck mobile and static screening units.
PACS & Digital MammographyProject
Following a comprehensive review of the evidence base and a period of clinical evaluation in the screening programme, BreastCheck will commence screening in Cork and Galway using digital mammography technology.
Digital technology allows mammograms to be acquired directly in a digital format without the requirement for film and film processing as used inconventional mammography. A state of the art PACS (picture archiving and communications system) isused for managing and storing the clinical image data and for presenting the images to the radiologists for reporting.
Replacement of conventional screening equipmentwith digital technology in the existing Merrion Unit is now complete and is underway at the Eccles Unit and the existing mobile units.
This year, two new mobile digital mammography units were added to BreastCheck’s existing fleet of mobile screening units. The integration of these unitshas been successful and we believe that the use of digital mammography imaging in a mobile setting will enhance the quality and consistency of service and will offer improved flexibility in the deployment of mobile screening units.
Development work continues to take place on a phased basis with respect to the integration and interface of the digital imaging systems with BreastCheck’s existing information systems to enable realisation of the most efficient use of the system and to ensure the highest levels of data quality.
Advertising
An extensive new advertising campaign was developed to provide public information about the BreastCheck service and to encourage women to participate in the Programme, where available. Any advertising undertaken aims to support and leverageto full effect BreastCheck’s ongoing and extensive screening promotion programme.
Imagery featuring 16 women aged between 50 and 65 years, representing all walks of life was developed to create a sense of solidarity and reassurance and to ‘normalise’ the BreastCheck experience.
A multifaceted approach, using television, radio and print media was devised to communicate clear messages and facts about the service and to encourage uptake among invited women.
Conclusion
I am delighted to share the immense progress that has been made by BreastCheck throughout 2006 and early 2007. Over 63,000 women participated in the BreastCheck programme in 2006 and acceptance of invitation reached 78.1%, the highest level of acceptance since the Programme began.
I would like to thank the staff of the Hospital Planning Office for their support. In 2006 the target for admission to hospital was exceeded for the first time since the Programme began with 94.4% of women diagnosed with breast cancer admitted for treatment within three weeks of diagnosis.
I wish to pay tribute to the work of our colleagues at the Cancer Policy Division and in particular acknowledge the contributions made by Mr.Gerry Coffey, Principal Officer. I would also like to welcome his successor Ms.Mary Jackson and wish her every success inher new role.
I would like to take this opportunity to congratulatethe management and staff of BreastCheck, and in particular of the Merrion Unit for their efforts in achieving the early commencement of screening in the Expansion area with the opening of a digital mobile unit in Roscommon. To date over 1,200 women have been screened in the area and the unit is scheduled to remain in Roscommon into 2008.
We are committed to the continued delivery of a quality assured screening programme that uses specialist expertise and multi disciplinary teams to achieve our goal of reducing the number of deaths from breastcancer through early detection and treatment. Since our last Annual Report, significant progress has been made as our service expands nationwide. I would like to thank the members of the National Breast Screening Board (which ceased to exist on 31 December 2006) for their dedication to the Programme.
As CEO of BreastCheck it gives me great pleasure to recognise and commend the support and commitmen tof our Board members ,the Chairperson, Dr Sheelah Ryan and Majella Byrne, Chairperson of the National Expansion Operations Group. I would also like to thank Clinical Directors Dr.Fidelma Flanagan (Eccles Unit), Dr. Ann O’Doherty (Merrion Unit) and new Clinical Directors Dr. Alissa Connors (Southern Unit) and Dr. Aideen Larke (Western Unit) for their tremendous efforts in launching the BreastCheck service into the South and West.
In conclusion, I wish to thank all staff, clinicians and the management team of BreastCheck for their enthusiasm, dedication and continued hard work indelivering BreastCheck, a service of excellence, to thewomen of Ireland.
Tony O’Brien
Director
November 2007
(from the Annual Report 2006/2007)
BreastCheck Programme Statistics 2006 (to come soon as html file)
Download full Annual Report 2006/2007:
English (.pdf file 1,568 kb, 36 pages - A4 format) BC-areport0607eng.pdf
Irish (.pdf file 1,447 kb, 36 pages - A4 format) BC-areport0607irish.pdf