Hansard

As Richard Simpson said, the SIGN guidelines for breast cancer recommend the immediate offer of breast reconstruction to all appropriate patients, but we are aware of the variability in the situation. That is being addressed as part of the capacity-building work in implementing the new cancer access targets—indeed, it is very much an element of that work. I am happy to keep Mary Scanlon briefed on the matter as we take it forward.

Breast cancer awareness month is an opportunity for people to talk about breast cancer, to share their experiences and concerns, to find out about services on offer, to learn what steps to take to protect against the disease and, importantly, to learn how to recognise symptoms. I am pleased to state the Government's support for the initiative, and I encourage everyone here today to ensure that we make the most of the awareness month.

It is now nearly a year since the launch of "Better Cancer Care", our cancer action plan. In that year we have already made significant progress against many of the tough commitments that we set, but there is still more to do.

Prevention is an important issue. We have noted that breast cancer incidence is increasing, but a breast cancer diagnosis is, of course, not always inevitable; there is mounting evidence to suggest that women can help protect themselves in all sorts of ways. "Better Cancer Care" outlines lifestyle choices that can help reduce people's risk of cancer. It is not only about raising awareness of the known risk factors; it is now about targeting the risk factors for many cancers—including breast cancer—such as alcohol, diet, physical activity and smoking. Having said that, I recognise Margo MacDonald's point that there are complexities around causal links, whether it be hormonal links or the environmental issues that she mentioned.

I will talk about research shortly, but I want to mention the increasing awareness of the links between breast cancer and alcohol. The risk of breast cancer increases as a result of drinking as little as one to two units of alcohol per day. More than one in 10 breast cancer deaths are estimated to be attributable to alcohol consumption, which is a very high figure. That is one reason why we have launched a three-year alcohol health behaviour change campaign, which this year is focusing on women and is trying to get the message across about the links to breast cancer.

We are also aware that more needs to be done on raising awareness of cancer symptoms and preventive measures. The Scottish cancer task force, established to oversee the commitments made in "Better Cancer Care", has consulted the three regional cancer networks in Scotland and the Scottish cancer coalition, which includes representatives from Breakthrough Breast Cancer—I pay tribute to the important work that it carries out—Breast Cancer Care and the Scottish Breast Cancer Campaign, to see how we can work in partnership with the voluntary sector to improve awareness raising of preventive measures in the future. I hope that that, in part, answers Angela Constance's question on the issue.

Although prevention is the first step to reducing the incidence of breast cancer, screening for early signs of the disease is equally important. As part of our breast screening programme, we are now screening more women and detecting more cancers earlier than ever before, which will save even more lives.

In response to Rhona Brankin's question about automatic call-up, we obviously take our advice from the United Kingdom screening advisory group, which considers the best evidence, but we will ask the Scottish national advisory group to consider the announcements made down south and what they mean for Scotland. The Scottish national advisory group is also undertaking a scoping exercise about lymphoedema services in Scotland, and I am happy to keep members informed about that.

Supported by £11 million of additional funding, two-view mammography is being rolled out nationally, and NHS boards are preparing to treat the additional breast cancer patients that will be diagnosed as a result of the programme. That partly answers Richard Simpson's point about accurate diagnosis.

I am sure that everyone in the chamber agrees that women with breast cancer deserve the highest standard of care. That is why we have committed to ensure that patients have access to the most up-to-date treatments and technology, no matter where they live in Scotland.

We have invested £4.1 million to support vital cancer research projects, some of which have a specific focus on breast cancer. There are currently 15 multicentre clinical trials on breast cancer, including the post-operative radiotherapy in minimum-risk elderly trial—PRIME II—which aims to assess clinically the role of post-operative breast radiotherapy. In Scotland, the PRIME II study is located in Edinburgh and supported by £145,000 of funding from the chief scientist office.

I will speak now about living with cancer. The increase in the five-year survival rate is excellent news, but it means that more and more women are living with, and beyond, a breast cancer diagnosis, which presents new challenges for patients, carers and families. We are working with health care providers in both the statutory and voluntary sectors to find ways of empowering and supporting patients, giving them the confidence and tools to maintain the level of independence that they desire.

In August, we hosted the big cancer conversation, an event for patients to tell us about issues that they are facing or have faced as a result of a cancer diagnosis. The outcomes from the event are being used to develop the work plan of the living with cancer group, which aims to address patients' physical, emotional, practical and financial needs post treatment.

At the launch of "Better Cancer Care", we announced the Scottish Government's investment of £500,000 to extend Macmillan Cancer Support's work, including its network of benefits advice services and its trialling an employability programme to support people with cancer in returning to work when appropriate.

Better treatment options, early detection and a successful breast cancer screening programme are reflected in Scotland's improving breast cancer survival rates. I am pleased to note that we are already exceeding our target to reduce overall cancer mortality by 20 per cent by 2010, and we are confident that the steps that we are taking will help us to aim even higher.

Despite the early successes, we are by no means complacent. We are working to raise awareness of the small changes that can be made in everyday life to reduce the risk of developing breast cancer. We very much recognise that there is work to do to target some harder-to-reach communities—and we are working on that.

Of course, we would not be taking any of that action had it not been for the effort and contributions from patients, carers, voluntary groups, professional organisations and—importantly—NHS staff. I am very grateful for all their contributions, both in breast cancer awareness month and during the rest of the year.