Breast Screening

In 2008, the lifetime risk of a person developing breast cancer was 1 in 8 (that means that 1 in every 8 women may develop breast cancer at some time in their life.

The risk of breast cancer increases with age. 80% of all breast cancers occur in post menopausal women. The risk continues to increase as a woman gets older.

Breast cancer is very rare indeed in women during their teens and early twenties and is uncommon in women under the age of 35.

Surviving Breast Cancer

Unfortunately some people do die as a result of breast cancer. In 2008, 12,047 women and 60 men died from breast cancer.

However, more and more people are surviving and treatments from breast cancer are now very successful. Based on figures from 2006, 82% of people diagnosed with breast cancer survived beyond 5 years.

The stage at which breast cancer is detected greatly increases the chances of survival. Generally, the early the cancer is detected, the greater the chances of survival.

Causes of Breast Cancer

The exact causes of breast cancer are not clearly known, but there are a number of factors which can increase the chances of a person developing breast cancer.

Age is one of the biggest risk factors and the risk of developing breast cancer increases with age.

In some women, there may be a genetic link to breast cancer. There are 2 genes which have been found to be factors associated with breast cancer, especially where there is a family history of breast cancer. The two genes have been found in 85% of families where there have been four or more family cases of breast cancer. However, only around 5% of all breast cancer cases are caused by the breast cancer genes.

Other known risk factors for breast cancer include:

  • previous personal history of breast cancer
  • not breastfeeding long term
  • current use of hormone replacement therapy
  • having no children or few children
  • having children at late ages (especially over 30)
  • early puberty
  • having a later menopause
  • obesity (for post-menopausal women only)
  • high consumption of alcohol
  • low levels of physical activity

What is Breast Screening?

Breast screening is a method of detecting breast cancer at a very early stage. The first step involves an x-ray of each breast - a mammogram, which is taken while carefully compressing the breast. Most women find it a bit uncomfortable and a few find it a little painful. The mammogram can detect small changes in breast tissue which may indicate cancers which are too small to be felt either by the woman herself or by a doctor.

What happens in the NHS Breast screening programme?
The NHS provides breast screening free of charge, once every 3 years, to all women between the age of 50 and 70 years of age. The NHS is extending the age range for the breast screening programme so that women between 47 and 73 years will be invited over the next few years.

The breast screening unit
Most women will be invited to attend for breast screening at a local hospital. Some areas have mobile units which can carry out mammograms in various community settings.

The invitation
Every woman who is registered with a GP will receive their first invitation letter from the local screening unit between her 50th and 53rd birthday. She will then be invited every 3 years until her 70th birthday.

Any woman who has special needs, such as a physical or a learning disability, can contact the breast screening unit at the address shown on the invitation letter. The screening unit can arrange a special appointment, usually at the hospital screening unit, where there is easier wheelchair access, better provision for a supporter to accompany the woman if she wishes, and more time can be allowed than is possible on a mobile screening unit.

Breast Screening Video

 

 

 

 

 

Click on the image to be taken to a web link showing part one of a video about breast screening

At the Screening Unit

A visit to a screening unit for breast screening takes about half an hour. The woman is greeted by a receptionist who checks her personal details (name, age and address). The mammography practitioner will ask the woman about any symptoms or history of breast disease, explain everything you need to know and answer any questions you might have. The mammography practitioner then takes the mammogram. She explains when and how the woman will get her results, and what happens next.

Breast Screening Video 2

Click on the image to be taken to a web link showing part two of a video about breast screening.

The Mammogram

The mammogram is a low dose x-ray. Each breast is placed in turn on the x-ray machine and gently but firmly compressed with a clear plate. The compression only lasts a few seconds and does not cause any harm to the breasts. Compression is needed to keep the breast still and to get the clearest picture with the lowest amount of radiation possible. Some women find compression slightly uncomfortable and some feel short-lived pain. Research has shown that for most women it is less painful than having a blood test and compares with having blood pressure measured.

Breast Screening Video 3

Click on the image to be taken to a web link showing part three of a video about breast screening.

The Results

The ResultsThe mammograms are examined and the results sent to the woman and her GP within two weeks. In 2008/09 around 8.6 per cent of women attending for a first screen, and around 3.2 per cent of those attending a subsequent screen, were asked to go to an assessment clinic for a further mammogram, either for technical reasons (if the picture was not clear enough) or because a potential abnormality was detected. For most women, no further investigations will be needed and they will be recalled for their next mammogram in 3 years. For all women, it is still important to be aware of the signs and symptoms of breast cancer between screens.

Further Investigation

At the assessment clinic, more tests are carried out. These may include a clinical examination, more mammograms at different angles or with magnification, or examination using ultrasound. A needle test (core biopsy) to sample the breast tissue may be carried out if the further tests confirm an abnormality. Core biopsy is done with a local anaesthetic.

Breast Screening Video 4

Click on the image to be taken to a web link showing part four of a video about breast screening.

Open Biopsy

Some women (less than one per cent), may need a biopsy.

What Happens if Cancer is Found?

If a woman is found to have cancer, she is referred to a consultant surgeon for a discussion of the options available to her. This is essential before making any decisions on treatment. Many women have a choice about the type of treatment they receive depending on the type and location of their cancer.

Is there anyone to talk to?

Assessment clinics have a specialist breast care nurse available to give advice and help to women who are undergoing diagnostic tests or who have been diagnosed as having breast cancer.

Treatment

This usually involves some form of surgery: a lumpectomy where just the lump and a small amount of surrounding tissue is removed, or a mastectomy where the whole breast is removed. Surgery is likely to be followed by radiotherapy, chemotherapy or hormone therapy or a mixture of these. The exact course of treatment will depend on the type of cancer found and the woman's personal preferences.
Breast screening may detect cancer. But regular screening means that any changes are more likely be found very early stage when the cancers are more easily treated and treatment is more likely to be successful.

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