§ Mr. CoakerTo ask the Secretary of State for Health (1) what progress is being made with respect to the building of a new breast cancer unit at Nottingham City Hospital; and if he will make a statement; [102226]
(2) what discussions he has had with Trent Regional Health Authority about the proposed new breast cancer unit at Nottingham City Hospital. [102225]
§ Yvette Cooper[holding answer 14 December 1999]: The National Health Service Executive Trent regional office has received an outline business case for a new breast care unit from Nottingham City Hospital NHS 310W Trust. When the Department's capital allocations for 2000–01 are announced, this project will be considered along with other priorities.
§ Mr. ChaytorTo ask the Secretary of State for Health (1) what research he has commissioned on the success rate for pre-operative diagnosis of breast cancer of the triple assessment method.[101983]
(2) what research he has commissioned on the success rate for pre-operative diagnosis of each of the following forms of assessment for breast cancer (a) clinical examination, (b) mammography or ultrasound and (c) fine needle aspiration or core biopsy. [101982]
(3) what percentage of breast cancer assessments are made by the use of the triple assessment method; and if he will list the figures for each NHS trust. [101984]
§ Yvette Cooper[holding answer 15 December 1999]: We fund health and medical research, including that for breast cancer, in a number of ways.
The Department funds research and development to support its work on policy development and evaluation in health and social care. The Department also manages the National Health Service research and development levy, which is used to support research and development of relevance to the National Health Service in hospitals, general practice and other health care settings, and to fund the NHS research and development programme. In addition, the Medical Research Council (MRC)—which receives most of its income via grant-in-aid from the office of my right hon. Friend the Secretary of State for Trade and Industry—funds medical research as part of the Government's funding of the science and engineering base.
There is strong existing research evidence for the value of using the combination of clinical examination, mammography and fine needle aspiration cytology (FNAC) known as "triple assessment" to diagnose cancer in women with breast lesions. A review of 15 follow-up studies showed that triple assessment is consistently more sensitive than any single test alone, capable of picking up 95 per cent. to 100 per cent. of cancers when at least one component is positive. When all three tests give the same result, whether positive or negative, the probability that the diagnosis is correct is about 99 per cent. In most cases, therefore, women with three positive tests can be offered therapy and those whose tests are all negative can be reassured without the need for surgical biopsy. In addition, triple assessment can be carried out in a single visit, reducing the time to achieve a definitive diagnosis.
"Improving Outcomes in Breast Cancer" was issued in 1996 by the NHS Executive Headquarters to provide evidence-based guidance on commissioning breast cancer services in the NHS. This recommends the use of triple assessment. A synopsis of the research evidence underlying the guidance was published alongside the guidance. Copies of both documents are available in the Library. We have invested an additional £30 million since 1997–98 to improve breast cancer services, building on this guidance.
Information on the use of triple assessment is not collected centrally.