St. Luke’s Lecture 1995

06/12/1995 in Royal College of Physicians of Ireland, 6, Kildare Street, Dublin 2

Thomas F. Gorey, Department of Surgery, Mater Hospital, Dublin 7

Advances in breast cancer: Clinical and biological lessons from screening

TF Gorey: “Mr. Chairman, Mr. President, Ladies and Gentlemen, it is indeed an honour to be invited to deliver the annual St. Lukes Cancer Lecture. I want to start by acknowledging the previous St. Lukes lecturers; while the subject was always cancer, over the years it covered the entire spectrum of basic biology and clinical practice in a whole range of cancers. As you can see from the list, 10 years ago the lecture was delivered by Dr. Dermot O’Donoghue and 20 years ago the first lecture was delivered by Professor James Fennelly. Two of my colleagues in the Mater involved in the breast programme have previously delivered the Lecture: Dr. Des Carney in 1982 and Professor Joe Ennis in 1984. Three surgeons have been St. Luke’s lecturers; Mr. Brian Hurson in 1988 on bone cancer, Mr. Gerry O’Sullivan in 1990 on gastric cancer and Mr. Tom Walsh in 1994 on oesophageal cancer.

What I want to say this evening concerns cancer in general and breast cancer in particular. Cancer has been known and feared since antiquity and the first written reference to cancer was in the Edwin Smith papyrus from 1600BC that curiously refers to a male breast tumour. Next year worldwide 10,000 males will die of breast cancer – I thought I would start with that statistic to wake up those men in the audience who are now sitting comfortably into their chairs, secure in the belief that breast cancer will never strike them directly, while it does of course when a female family member is afflicted. During the next year around the world, 1 million females will die of breast cancer and this is all the more important as many will be an the prime of life in the 40 to 50 age group. During the Vietnam conflict, that catharsis in American Society, 60,000 U.S. soldiers were lost during the war. During the same period at home 330,000 American women died of breast cancer. In this evening’s lecture I will start with some basic facts and statistics about breast cancer using slides from the undergraduate medical student teaching programme. I am going to talk about screening in general and the difficulties and criticisms particularly of breast screening programmes. I will then give some statistics from the ECCLES breast screening programme based at the Mater Hospital Dublin. I will go over the surgical principles in managing breast cancer and in particular the approach to excising non-palpable and invisible tumours picked up on screening. Finally, I will show some of the research applications carried out jointly between the department of Surgery and other departments on data from the screening programme.

Irish Journal of Medical Science July, August, September, 1996, Volume 165, Issue 3, pp 143-150

The Acting Chairman of St. Luke’s Hospital presented the silver medal and honorarium and thanked the speaker for an excellent lecture.

This being the twentieth St. Luke’s Lecture since its beginnings in 1975.