Hansard

I thank the members who have taken the time to attend and to participate in this debate on a hugely important issue.

I begin by remembering Margaret Ewing, the former and much-loved MSP for Moray, who tragically lost her life to breast cancer in March 2006. I am sure that she will be in the thoughts of members across the chamber. Of course, each of us will have been touched by breast cancer in some way. I have had the illness, and everybody in this room has a wife, a mother, a granny, an auntie or a sister who has been touched by the illness over the years. I welcome the opportunity to debate the issue this month. Today's debate offers us a platform to discuss the most prevalent form of cancer that is diagnosed in Scottish women, and further raises the profile of a disease that kills 1,000 women in Scotland every year. I thank the members of all political parties who have signed the motion in my name.

I will begin on a challenging note by setting out the scale of the problem that continues to face Scottish women, our health service and the voluntary sector. It is a hugely disappointing statistic that one in six women cannot name any sign or symptom of breast cancer, and it is more disappointing still that nearly a quarter of women cannot name a breast lump as a sign of breast cancer and that only a third of women regularly check their breasts or are breast aware.

Further, two thirds of women are not aware of the increased risk that comes with age, and a quarter of women over the age of 65 never check their breasts, despite that increased risk.

Those statistics need not be disheartening; indeed, they can embolden us. It is a necessary evil in all walks of policy making that we must sometimes reduce complex issues, including those that often yield devastating and unquantifiable personal losses, to a numbers game. The grim statistics that I have outlined should not mask the encouragement that one can take from the numbers. It is encouraging that up to 40 per cent of breast cancer cases could be avoided each year by leading a healthier lifestyle, which includes maintaining a healthy weight, exercising regularly and reducing alcohol consumption. That effect equates to around 1,600 cases per year, which is 1,600 fewer cases on the books of the national health service and 1,600 fewer women—mothers, daughters and sisters—who have to sit their families down and explain that they have been diagnosed with cancer. Despite improvements in survival rates in recent years—there has been a 12 per cent drop in the mortality rate in 10 years—it is tragically inevitable that too many of those families will be left without a mother, a daughter or a sister.

Although, on the face of it, leading a healthier lifestyle may seem to be one of the simplest approaches to tackling breast cancer and ill health more widely, it presents perhaps one of the most significant challenges that policy makers and the charitable sector face: getting a deep culture shift through a coherent and concurrent approach that threads together many areas of public policy and responsibility.

That challenge is not insurmountable, and the work of Breakthrough Breast Cancer, Breast Cancer Care Scotland, the Scottish Breast Cancer Campaign and others has shown to great effect that working together to create a coherent strategy can make all the difference. Awareness of breast cancer now enjoys a prominent public profile, for which we have the tireless work of those organisations to thank. As I am sure that they would be the first to tell you, however, there is still much to be done.

As I said, statistics are a necessary evil in informing us how to target policies more effectively, but I will leave them behind for a moment. To contextualise the statistics and drive home the debate I will highlight the case of a woman in my constituency. That lady, having sadly lost her mother to breast cancer, had a heightened awareness of breast cancer and was in the habit of checking her breasts regularly for any lumps or signs of change. When she found a lesser-known symptom of breast cancer, she was unaware that it was one, put it to the back of her mind and forgot about it.

Later that year, when she was out shopping, she picked up a Breakthrough Breast Cancer campaign leaflet. It listed the symptoms of breast cancer to look out for, some of which are commonly known, others less so. After finding listed the symptom—a wrinkling on her breast—that she had noticed in herself earlier that year, she resolved to get it checked, and she was diagnosed, as her mother had been, with breast cancer. Thanks to a relatively early diagnosis and treatment, that lady's long-term prognosis is now good. She admits:

"I was lucky because despite ignoring the first warning sign, when I did get diagnosed it was still early enough to remove the cancer before it could spread. Why I didn't get my first niggling doubt checked now seems unbelievable. I was someone who did all the checks. I am an intelligent person. Yet it was so small and I could not feel a lump. But now I know there are other signs and symptoms of breast cancer. It is not just about whether you can see or feel a lump. I strongly urge other women to regularly touch, look at and check their breasts and no matter how small or trivial their worry is to share it with their GP immediately."

That is good advice. All women—and indeed men—should be breast aware, and if they notice any change in their breasts, they should speak to their general practitioner.

I share with Breakthrough Breast Cancer the belief and aspiration that through research, campaigning and awareness, breast cancer can be beaten and the fear of the disease removed for good. That will be difficult, but it is not beyond our capacities. The Breakthrough Breast Cancer-funded research unit at the University of Edinburgh is the only unit in Scotland that is dedicated to researching breast cancer. It aims to improve breast cancer treatment and ensure that patients are treated in the most appropriate and effective way for their particular type of breast cancer.

The unit brings together some of the best Scotland-based scientists and doctors who are involved in treating breast cancer to develop a centre of excellence for world-class breast cancer research. It focuses on hormone-sensitive breast cancer, which is the most common form of the disease and affects tens of thousands of women—previously including me. Although there are some excellent treatments available for hormone-sensitive breast cancers, some forms become resistant to them. At Edinburgh, Breakthrough Breast Cancer scientists are looking for the causes of drug resistance and ways to overcome it.

Breakthrough Breast Cancer believes that the patient experience for breast cancer should be improved by NHS boards and hospitals, by listening and responding to the views of patients through models such as the Breakthrough service pledge. I am sure that all members are aware of instances in which people with breast cancer who have to attend clinics for difficult treatments have had problems with transport or whatever. It is not an easy disease and the treatment is very difficult in many cases. I certainly support Breakthrough Breast Cancer's call on the Scottish Government, NHS Scotland, local authorities, health groups and individuals to take action to increase awareness among women of the signs, symptoms and risk factors associated with breast cancer and to increase the number of women who attend breast screening appointments.

There was an announcement yesterday by Gordon Brown about making moves to take on the challenge, and I would be grateful if the minister could indicate whether, given the successful evaluation of the breast cancer screening programme, she will give a commitment to do what Gordon Brown has committed to do and extend the range for automatic call up for breast cancer screening to 73 years at the top end and 47 years at the bottom. Following on from my own experience of breast cancer, can the minister also provide me with the up-to-date guidance that is provided to women on what to do about hormone replacement therapy and the links between HRT and breast cancer?

I conclude by extending my thanks to Breakthrough Breast Cancer, Breast Cancer Care Scotland and the Scottish Breast Cancer Campaign for their ceaseless efforts. I particularly thank Breakthrough Breast Cancer for asking me to host this evening's debate; I was delighted to agree to do so. Once again, I thank all those members who have taken the time to attend and to participate in the debate. [Applause.]