Breast cancer outcomes following predictive BRCA testing in Northern Ireland

Objectives: Since 1995, BRCA testing has identified 445 women in Northern Ireland who carry a pathogenic BRCA1/2 mutation, without breast cancer (bca) at testing. This study examined outcomes with reference to management, bca risk, and incidence following positive predictive testing. Methods: Patients were identified from the regional genetics database. Electronic clinical records were used to obtain management and outcome details. Median follow-up was to bca diagnosis, risk-reducing mastectomy (rrm), death, or last follow-up. Results: 169 women had a BRCA1 mutation, and 276 BRCA2. ■ BRCA1 cohort: Median follow-up post-testing was 3 years. 56 Women (33%) had rrm, and 12 are awaiting rrm (total 68, 40%) at a median age of 36 years. 12 Women (7%) developed bca, at a median of 2 years following testing. 4 Women were diagnosed with bcas incidentally at rrm. 7 Patients had bilateral mastectomies following a cancer diagnosis. 1 Woman developed bca following rrm (1.7%). Three deaths were reported: 1 breast cancer (1.7%), 1 ovarian cancer (1.7%), and 1 with no recorded breast/ovarian cancer diagnosis. ■ BRCA2 cohort: Median follow-up post-testing was 6 years. rrm was carried out in 75 women (27%), with 20 awaiting rrm (total 95, 35%); median age: 39 years. 16 Women developed bca (5.8%), at a median of 5 years from testing. 6 Women were diagnosed with cancer incidentally at rrm; 9 women had bilateral mastectomy following diagnosis, and 1 developed bca following rrm (1.3%). Five deaths were reported: 1 bca, 1 ovarian cancer, and 3 with no recorded breast/ovarian cancer diagnosis. Conclusions: The uptake of rrm following predictive BRCA testing in Northern Ireland is comparable with that reported elsewhere. The incidence of bca following rrm is low (<2%) in our cohort, with low breast and ovarian cancer–specific mortality following positive predictive testing.

Politics, Patriotism and Women in Ireland, Britain and Colonial America, c.1700-c.1780

The use of the consumer boycott as a political tool is commonly associated with pre-revolutionary colonial America and has been identified by historians as an important means through which American women were politicized. This article argues that from the late seventeenth century, Irish political discourse advocated the non-consumption of imported goods and support for home manufactures by women in ways that were strikingly similar to those used later in North America. In Ireland and, subsequently in the American colonies, the virtuous woman consumer was given an active public role by political and social commentators. Rather than being a “brilliantly original American invention,” as T. H. Breen has argued, the political exploitation of a consumer boycott and the promotion of local industry were among what Bernard Bailyn has described as the “set of ideas, already in scattered ways familiar” to the revolutionary leaders through the Irish experience. The article also argues that a shared colonial environment gave Irish and American women a public patriotic role in the period, c. 1700–1780 that they did not have in the home countries of England and Scotland.

A History of Women in Ireland, 1500-1800

The first general survey of the history of women in early modern Ireland. Based on an impressive range of source material, it presents the results of original research into women’s lives and experiences in Ireland from 1500 to 1800. This was a time of considerable change in Ireland as English colonisation, religious reform and urbanisation transformed society on the island. Gaelic society based on dynastic lordships and Brehon Law gave way to an anglicised and centralised form of government and an English legal system.

'Ancient Enmities' and Modern Conflict: History and Politics in Northern Ireland

This article investigates the role of history and historical consciousness in deeply divided societies. It looks at the case of Northern Ireland. It argues that, while the conflict here is caused by contemporary divisions, perceptions of the past have had considerable influence. Recent years have seen efforts to change historical attitudes and this has aided political accommodation. An important lesson from the conflict in Northern Ireland points to the need to challenge such historical perceptions.

Abortion and Nation: The Politics of Reproduction in Contemporary Ireland

Abortion politics are contentious and divisive in many parts of the world, but nowhere more so than in Ireland. Abortion and Nation examines the connection between abortion politics and hegemonic struggles over national identity and the nation-state in the Irish Republic. Situating the abortion question in the global context of human rights politics, as well as international social movements, Lisa Smyth analyses the formation and transformation of abortion politics in Ireland from the early 1980s to the present day. She considers whether or not the shifting connections between morality, rights and nationhood promise a new era of gender equality in the context of nation-state citizenship.
The book provides a new sociological framework through which the significance of conflict over abortion and reproductive freedom is connected to conflict over national identity. It also offers a distinctive in-depth consideration of the connection between gender and nationhood, particularly in terms of its impact on women's status as citizens; within the nation-state; within the European Union; and as members of a global civil society.