A High Court judge has granted permission for a mastectomy to be carried out on a mentally ill woman because she lacks capacity to consent to the surgery.
The High Court President Mr Justice Peter Kelly said the medical and psychiatric evidence showed the surgery was urgent and was in the woman's best interests.
The court heard the woman lacks understanding of the seriousness of her cancer and that a breast tumour discovered last October under the HSE's Breastcheck screening process was growing.
A solicitor recently appointed by the HSE for the woman said he explained to her in recent days that she could die unless she had the surgery.
The woman said she "would like to live" and was happy for the court to decide whether she should have the surgery.
The treatment orders were sought by the HSE as part of an application to have the woman made a ward of court. This application will be dealt with at a later date.
The woman, who is in her 50s, had told her psychiatrist her cancer was caused by excessive showering and that she could cure it by not having showers. She said it would "go away".
The psychiatrist said the woman also does not appreciate or understand the severity of her schizophrenia, which was untreated for 25 years until she came to the attention of the mental health services some years ago.
The woman also lacks insight about a serious and continuing physical illness for which she was previously admitted to hospital on an emergency basis, but sought to leave before receiving necessary life-saving treatment.
She was involuntarily detained, as a patient under the Mental Health Act, for that treatment and that detention was later extended when she said she would not take necessary medication for her mental and physical illnesses.
A Mental Health Tribunal later lifted the woman's involuntary detention, but she remains voluntarily in a support unit and regularly visits her siblings, also with mental health difficulties, in the family home.
Her parents are dead and she has some assets but the evidence indicated she lacks capacity to manage her personal or financial affairs and is vulnerable in both respects.