By Suzanne Lynch, Programme Manager, BreastCheck
Launched in February 2000, BreastCheck is Ireland’s national breast screening programme.
The programme was set up to reduce the number of deaths from breast cancer in Ireland by inviting women aged 50 to 64 for free mammograms (breast x-rays) every two years. Breast screening aims to find the early signs of breast cancer - before symptoms appear – when treatment is more effective.
At its inception, the number of deaths from breast cancer amongst women in Ireland was one of the highest in the EU, making the establishment of BreastCheck a crucial response to this public health challenge.
The birth of BreastCheck
The concept of a national breast screening programme emerged in the 1980s and 1990s. There was growing evidence that women aged 50 to 64 would benefit from regular breast screening, with studies showing that the early detection of breast cancer through mammography could significantly reduce death rates.
A pilot programme in Dubin and Monaghan in the 1990s, supported by the European Reference Organisation for Quality Assured Breast Screening and Diagnostic Services (EUREF), laid the groundwork for a national initiative including establishing robust quality assurance structures.
In February 2000, screening began in the Eastern region at the Eccles unit in the Mater Hospital and at the Merrion Unit in St. Vincent's University Hospital. These locations were strategically chosen based on their expertise in breast cancer care. The units operated in tandem with mobile units to serve surrounding counties.
Mobile units
Mobile screening units have been a cornerstone of BreastCheck, improving accessibility and efficiency. Most women taking part in BreastCheck have their mammogram in one of these units.
The first mobile unit set down in Longford in August 2000 with a second in Kildare. By 2002, five mobile units were operational, and by 2009 the number had grown to 15 as the programme expanded nationally.
Today, 24 mobile units operate across 54 locations, ensuring women can access screening close to where they live.
The first two years
During its first two years, BreastCheck focused on achieving quality assurance targets and building awareness among eligible women.
The programme invited 60,881 eligible women for screening, and 45,321 attended for screening – achieving an uptake rate of 73% and exceeding its target of 70%. Of the women screened, 210 were diagnosed with breast cancer, resulting in a detection rate of 9.1 per 1,000 women screened, well above the target of 7 per 1,000.
These results established BreastCheck as a high-quality service and set the stage for national expansion. In March 2003, the then Minister for Health, Micheál Martin TD, approved plans to extend the programme to the entire country.
Expansion
The national rollout happened in two phases: the extension of services in the Eastern area and expansion to all other parts of the country.
Screening units were established in University College Hospital Galway and the South Infirmary Victoria Hospital in Cork to serve the West and South respectively, supported by additional mobile units. By the end of 2009, BreastCheck had started inviting eligible women for screening in all counties.
In 2015, the eligible age range was extended to include women aged 65, and by 2021, all women aged 65 to 69 were included. This change reflected emerging evidence that screening benefits women in this age range.
A quality-assured programme
From the outset, commitment to quality assurance and continuous improvement has been at the heart of BreastCheck. In keeping with the principles of the National Health Strategy at that time, we adopted a person-centred approach with the programme delivered within the framework of a Women's Charter, which we updated in 2025.
Independent audits, such as a 2005 review by NHS Quality Improvement Scotland, confirmed that BreastCheck met or exceeded critical standards.
EUREF, the European breast screening quality assurance organisation, played a key role in accreditation, with a pre-certification visit in 2002 helping the programme prepare for full certification. Since then, BreastCheck has been accredited three times by EUREF, achieving our most recent re-certification in April 2025, and continuing our tradition of excellence and accountability, while further building trust and confidence in the programme.
Our programme standards are based on the European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis, and in recent years we have contributed to the ongoing development and improvement of these guidelines.
Embracing advancements in technology
BreastCheck has consistently embraced technological advancements to improve the screening process. In 2008, we became the world’s first national breast screening service to fully adopt digital mammography, which offered improved image quality and consistency compared to traditional film-based imaging. This milestone significantly improved diagnostic accuracy.
More recently, we have started exploring the potential of artificial intelligence in breast cancer screening, hosting a workshop in 2024 to examine its benefits and challenges.
Another significant development came in 2024 with the introduction of a modernised patient database system. Aligned with the HSE’s Digital Health Strategy, this system streamlines the screening process and improves data management. We are now better equipped for the future to offer more efficient care, improving the entire screening journey for women taking part in the programme.
Communications and information for women
From the beginning, we prioritised clear and effective communications to support eligible women to make an informed choice about taking part in breast screening. Early campaigns included outdoor and print advertising, and Marian Finucane became a familiar voice of our radio advertising. We launched our website in 2002 and used TV as an advertising medium for the first time in 2005.
Our communications evolved based on research and feedback. Surveys, focus groups and market research provided insights into women’s attitudes and the barriers and motivators to screening. This gave us the evidence-base to improve our messaging.
An access team was developed in 2011 to support women with disabilities to take part in screening and remains in place today. Efforts to improve equity included the development of multilingual resources and initiatives to address health literacy. Materials were made available in various accessible formats including braille, audio, video tape and DVD. A pictorial tool was developed in 2010 to help women with intellectual disabilities understand the screening process.
Today, we continue to offer a comprehensive suite of accessible information for our screening participants, including easy-to-read and plain English resources, visual stories using photos and videos, videos in multiple languages, and videos with Irish Sign Language.
Challenges along the way
The early years of BreastCheck were marked by a shortage of radiographers, and a major international recruitment drive was put in place at the time. Workforce challenges have persisted, with global shortages of radiologists and radiographers posing ongoing difficulties. Despite these hurdles, we have maintained high standards through robust workforce planning and staff development initiatives.
The Covid-19 pandemic presented unprecedented challenges, causing a nine-month pause in screening during 2020 and 2021. Infection prevention measures, missed and cancelled appointments, and staff absences due to Covid-19 further impacted operations. The resilience of our staff and their ability to adapt and implement innovative solutions ensured we could maximise capacity during this time.
The impact of BreastCheck
In its 25 years of operation, BreastCheck has performed over 2.6 million mammograms and detected over 18,000 cancers. Around one-third of all breast cancer cases diagnosed annually in Ireland are identified through the programme.
A 2022 report published by the National Cancer Registry Ireland shows that BreastCheck has significantly contributed to early-stage cancer diagnoses and reduced cancer-related deaths among women in the screening age range. These achievements underscore the programme’s life-saving impact and its vital role in Ireland’s healthcare system.
Looking to the future
BreastCheck is part of the HSE’s National Screening Service, which runs three other national screening programmes – CervicalCheck, BowelScreen and Diabetic RetinaScreen. We all share a strategic vision – to work together to save lives and improve people’s health through population screening.
The dedication and expertise of our staff has been central to the success of BreastCheck. Looking ahead we’ll continue to uphold quality standards, embrace innovation, and adapt to new challenges, ensuring we remain a cornerstone of Ireland’s healthcare system for decades to come.
As we mark 25 years of BreastCheck, our mission remains unchanged – to reduce the impact of breast cancer through early detection and to provide a high-quality, accessible screening service for women who choose screening.
- BreastCheck is for women aged 50 to 69 who have no symptoms of breast cancer. If you have symptoms or any concern about your breasts talk to your GP.
- Be breast aware and check your breasts regularly. Get to know what is normal for you and your breasts, so you’ll notice any unusual changes. When breast cancer is found early, treatment is more likely to be successful.
- In 2021, Dympna Cremin was diagnosed with breast cancer after a screening mammogram with BreastCheck. After having successful surgery and radiotherapy, Dympna shares her story to encourage other women to go for screening every time they’re invited.
- Making BreastCheck work for everyone – 5 things you should know