Sir, - Prof Niall O'Higgins (November 15th) explained that, no matter how dedicated an individual doctor is, optimum care cannot be provided consistently in small units. Next day I read in The Irish Times: "There was great relief in Mayo yesterday that the breast cancer unit in Mayo General Hospital in Castlebar is to be retained".
The comprehensive report produced last March by the subgroup to the National Cancer Forum, "Development of Services for Symptomatic Breast Disease", recommends specialist units for diagnosis and treatment based on a population of 250,000 to 300,000. This is in accord with recommendations made at the conclusion of the second European Breast Cancer Conference in Brussels in October when a document on key issues was produced by the delegates. I quote: "The Conference demands that national governments establish and accredit breast units in their countries in accordance with the guidelines and ensure that cancer diagnosis and care are carried out in these units".
The document issued after the first meeting in Florence in 1998 contained a similar recommendation, and described the units as fully equipped multi-disciplinary and multi-professional breast clinics based on populations of around 250,000.
The Department of Health and Children deserves out gratitude and support for its commitment to implement the recommendations contained in the report. We cannot expect an increase in long-term survival, if it is impeded in fulfilling its commitment by lobbyists in areas which do not qualify for specialist centres. - Yours, etc.,
Brenda wheeler, Rathfarnham, Dublin 14.