A Medical Council inquiry has been told that if a 40-year-old patient, who later died, had been referred for a routine mammogram in August 2007, she may have been waiting 18 months for it at the hospital.
A consultant radiologist was giving evidence on the second day of an inquiry that is examining allegations of professional misconduct against a consultant breast surgeon.
The radiologist said the service in the region at the time was massively under-resourced.
The consultant breast surgeon at the centre of the Medical Council inquiry said that, in 2007, the fastest he could get a mammogram performed was three months.
Dr C said that at the time, the proper resources for cancer diagnosis were not available in the region and he was doing clinics in three hospitals as there were not enough breast surgeons in Ireland.
He also said he could not face patients in the clinic to tell them they would have to wait for screening.
This was one of the reasons he underwent a course in Britain in 2007 to get qualification to use ultrasound, which an expert has told the inquiry was an inferior imaging check in the case before this inquiry.
Dr C said he qualified in medicine in 1985 and described himself as a perfectionist who wanted the best for his patients.
He told the inquiry that he was reassured after he saw and examined Patient K in August 2007.
He said the physical breast examination suggested a benign lump and he saw no abnormality on the ultrasound examination.
Dr C arranged for a three month follow-up in December, given that if a mammogram was required, it would take at least three months for a screening date.
Ten months after the August exam, the patient was diagnosed with breast cancer.
Following major surgery, chemotherapy and radiotherapy in mid- 2008, Patient K recovered, but later deteriorated and died in September 2012.
The manager overseeing breast cancer services at the hospital told the inquiry that she stood 100% behind Dr C's practice there.
She said she had sent family and friends to be seen by the consultant breast surgeon.
She said that Patient K did not attend a first referral to the Triple Breast Assessment Clinic on 1 August or a second appointment on 8 August 2007.
She told the inquiry that "Do Not Attend" rates on average are 10%-15% of cases.
The Medical Council inquiry has adjourned until tomorrow, which is the final day.