NHS Breast Screening Programme FAQs
NHS Breast Screening Programme FAQs |
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Frequently Asked Questions
I haven't been called for breast screening even though I'm over 50 - do I need to contact anyone?The NHS Breast Screening Programme is a rolling one which calls women from doctors' practices in turn. This means not every woman receives her invitation as soon as she is 50. It will be sometime between the ages of 50 and 53. If you are registered with a GP and the practice has your correct details, then you will automatically receive an invitation. You don't need to contact anyone but you might like to ask your surgery when the women on their list are next due for screening. My sister has already had her invitation for breast screening even though she's younger than I am. Have I been forgotten?It's probably the case that your sister is registered with a different GP and the women on her practice's list have been called before those registered with your GP. Check with your surgery that they have your correct contact details and ask them when the women on their list are next due for screening. I've found a lump in my breast - can you tell me how I can get a mammogram?The NHS Breast Screening Programme is a population screening programme which invites all women aged 50 to 70 as a matter of routine. It is not aimed at women who already have symptoms. So if you have found something that worries you or are concerned about your breast health, you should consult your GP in the usual way. He or she will decide whether or not you need to be referred for further investigations or treatment. Why doesn't the NHS screen younger women?Conventional mammograms are not as effective in younger women because the density of the breast tissue makes it more difficult to detect problems and also because the incidence of breast cancer is lower. As women go past the menopause, the glandular tissue in their breast "involutes" and the breast tissue is increasingly made up of only fat. This is clearer on the mammogram and makes interpretation more reliable. It can be compared with trying to spot a small bird in a tree - it's easier when there are no leaves on the branches! Digital mammography is better for screening younger women and denser breasts. It is equally effective as conventional mammography in post menopausal women. From 2012 the NHS Breast Screening Programme will be extended to invite women from the age of 47. My sister lives abroad and she gets more frequent breast screening. Why doesn't this happen in the UK?A large research trial in 2002 concluded that the NHS Breast Screening Programme has got the interval between screening and invitations about right at three years, compared with more frequent screening. The trial was organised through the United Kingdom Coordinating Committee on Cancer Research (UKCCCR) and was supported by the Medical Research Council, Cancer Research UK and the Department of Health. Here are the results from the UKCCCR Randomised Trial (PDF-186Kb) from the European Journal of Cancer, 2002. I'm worried that breast screening will hurt because of the size of my breastsDon't worry. The mammography practitioners are used to screening women of all sizes and will do their best to minimise any discomfort. During the mammogram 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 doesn't cause any harm. It's needed to keep the breast still and to get the clearest picture with the lowest amount of radiation possible. Some women do find compression slightly uncomfortable and some feel short-lived pain but research has shown that for most women it's less painful than having a blood test and compares with having blood pressure measured. I'm a researcher who needs to contact all the breast screening units - can I have their contact details?Sorry, we don't routinely give out such details. Women wanting to know the whereabouts of an individual breast screening unit will find it listed in their local telephone directory. Can I walk into the mobile breast screening unit and request a mammogram?Sorry, the NHS Breast Screening Programme doesn't operate on a walk-in basis. It invites women in the target age group (50 to 70) for routine breast screening every three years. So if you have found something that worries you or are concerned about your breast health, you should contact your GP in the usual way. Why does breast screening stop at 70?It doesn't. Although women over 70 are not routinely invited for breast screening, they are encouraged to call the local unit to request breast screening every three years . We produce cards to help them remember which are handed out at their last routine breast screening appointment. Please see Over 70? You are still entitled to breast screening for further information. From 2012, women will be routinely invited up to the age of 74. My company would like to organise breast screening for our employees. Can we have a mobile on site?I'm afraid the NHS Breast Screening Programme isn't organised like this. All breast screening units (including mobile ones) serve a defined population of eligible women (aged 50 to 70) who are invited for breast screening every three years through their GPs. If you are interested in encouraging women to be 'breast aware' and to accept their invitations for breast screening I suggest you contact your local health authority to see if they have health promotion people who could help you. I've read about a new breast screening technique. Why isn't it being offered by the NHS Breast Screening Programme?Before any new technology is introduced into the NHS Breast Screening Programme it must be thoroughly evaluated for both cost and clinical effectiveness. This ensures that we can provide the best possible service to the greatest number of women. Can women with a physical disability be screened?Mammography is a procedure which is technically difficult and which requires a high degree of cooperation between the mammography practitioner and the woman. The woman has to be carefully positioned on the x-ray machine, and must be able to hold the position for several seconds. This may not be possible for women with limited mobility in their upper bodies or who are unable to support their upper bodies unaided. If a woman has a physical disability, or is a wheelchair user, then the breast screening unit should advise on whether breast screening is technically possible. If a mammogram is not technically possible, the woman should still remain in the call and recall programme, as any increased mobility at a future date may make screening easier. If a woman cannot be screened she should be advised on breast awareness. Does taking Hormone Replacement Therapy (HRT) increase my risk of breast cancer?The risk of breast cancer is increased in women who take HRT for several years:
HRT, especially combined therapy, may increase mammographic density, which may adversely affect radiological detection of breast cancer. In the Women's Health Initiative trial, conjugated equine oestrogens (CEE) and CEE plus medroxyprogesterone increased the likelihood of having an abnormal mammogram that needed further evaluation. [From MRHA Drug Safety Update Bulletin Vol 1, Issue 2, September 2007] I am a carer, looking after someone who lacks the mental capacity to make their own decisions about screening. They have been invited for screening. How should I deal with their invitation?If the person you care for is unable to make their own decisions about screening, then you, as their carer, should make what is called a 'best interests' decision on their behalf, in the same way as you may be making other decisions about their care and treatment. You will need to weigh up the benefits of screening, the possible harm to them and what you think the person would have wanted to do themselves. Whether you are a paid carer, or an unpaid carer, family member or close friend, the process is the same. Some people may have fluctuating mental capacity, in which case, the decision about screening should be delayed until the individual is able to decide for themselves. If you do need to make a decision on someone else's behalf, you will need to consider what is involved in the screening process (including any further diagnostic tests that may be needed if the person receives an abnormal screening result). You may find it helpful to speak to their GP to discuss, for example, the person's risk of developing the cancer in question and how screening may affect them. You must also consider what you think the person themselves would want. For example, did they used to go to screening, or express an opinion about it? Did they express more general views about their health and whether they would want to know if they had a disease or condition? Or did they refuse screening in the past? Paid carers in particular should get advice from family members or friends about the person's views. If, after all this, you consider that screening is in the best interests of the person you care for, then you are within your rights to help that person to be screened. You should feel confident that if someone asks you, you will be able to explain the reasons for the best interests decision that you have made - either for, or against, screening. To find out about the breast screening process, please read our leaflet Breast Screening - The Facts and additional information can be found in the Cancerbackup booklet Understanding breast screening. To help someone with limited capacity to understand the screening process, you may find the picture leaflet An easy guide to breast screening helpful. To find out more on making a best interests decision, you can read Making decisions: A guide for family, friends and other unpaid carers [PDF 390Kb] from the Office of the Public Guardian. There is also Making decisions: A guide for people who work in health and social care [PDF 320Kb] on making best interests decisions. To find out more about consenting to screening, please read our Consent to cancer screening guidance. To find out more general information regarding consent and access to screening, please refer to our guidance Equal access to breast and cervical screening for disabled women. Could I have thermography for breast cancer screening instead of mammography? I am worried about the radiation I will be exposed to.Thermography is also called thermal imaging. It is a technique used to create a 'heat map' of the body. The colours in the map show the level of heat production in the tissues in that area. For cancer, the idea is that cancers will show up as hotter than normal tissues. Growing cancers rapidly form new blood vessels and this process produces heat. Thermography has been investigated as a possible breast screening test, but it isn't reliable enough. It gives a positive result in too many women who do not have cancer and it misses cancers that are there in other women. Thermography is not a replacement for mammography. It is a relatively new test and isn't reliable enough to use either to diagnose or screen for breast cancer. Mammography is still the best test. Many women are concerned about having regular mammograms and how much radiation this exposes them to over a number of years. In fact, the total amount of radiation is relatively small. Women have two 'views' taken each time they are screened for breast cancer with mammograms. Each view exposes them to less than 0.2 rads (the measure of radiation that is used most commonly). We are all exposed to 'natural' background radiation every day. This is increased if we fly in a plane, as we are closer to radiation from space and the sun. The amount of radiation per mammogram is about the same as you would receive if you flew from London to Australia and back. Or to look at it another way, the Health Protection Agency Radiation Protection Division have calculated that each mammogram exposes you to the same amount of radiation you would receive as background radiation over a few months. Their website also has a leaflet on radiation safety that you can download. If you have concerns about your breast screening then talk to your GP about it. But remember, the risks of breast screening are much smaller than the possible benefit of finding a breast cancer early enough to cure it. |
 Breast screening programme index What happens at a What are the risks of breast screening? Frequently Asked Questions (FAQs) DCIS (Ductal Carcinoma | ||||||||
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