THERE was a wide gulf between the best and worst practice in the diagnosis and management of breast disease, a leading specialist in breast cancer has said.
The professor of surgery at University College Hospital Galway, Prof Fred Given, who is also director of the National Breast Cancer Research Institute, said yesterday a woman who found a breast lump should be able to be seen in a specialist breast clinic after consulting her GP.
She should also be able to receive all diagnostic tests necessary, and be assured that she is not suffering from breast cancer, one visit. "The speciality of is now established and no longer should a patient be content with referral to any surgeon. She should be able to attend a breast unit where there is specialist expertise and support."
Speaking in Galway at a seminar to mark the inaugural meeting of the Irish Breast Care Nurses' Association, Prof Given stressed that breast units which were also active in research and at least participating in "multi centre studies aimed at improving treatment" were achieving success. "There is evidence to suggest that the patients treated in centres actively involved in research have improved outcomes."
He said mammography was not appropriate as the sole or initial diagnostic test. Additional approaches were necessary, as even palpable breast cancers might not be visible on a mammography, particularly in young women.
A Laois based GP, Dr Mary Sheehan, said GPs should learn to ask open questions with a psychological focus rather than concentrating solely on the disease's physical aspect. Specialist nurses were then available to offer emotional and practical support.
Most women who had a breast lump were emotionally distressed. "Up to 30 per cent of women with breast cancer develop an anxiety state of depressive illness within a year of diagnosis," she said.
The ICBNA founder, Ms Eva Costello, said its role would be to increase the number of nurses specialising in breast care and to establish their work as a medical speciality. She hoped to raise public awareness, especially on psychological support available, as one out of 11 Irish women develop breast cancer at some time.