About Screening

Information Leaflets - Breast screening explained

This leaflet tells you about free breast screening. Breast Test Wales is part of the NHS breast screening programme. Breast screening is for all women aged 50 and over.

1 What is breast screening?

Breast screening looks for breast cancer before symptoms show. This involves taking mammograms, which are x-rays of the breast. At least two mammograms of each breast are taken.

2 Why is it important?

Breast cancer affects one in nine women living in Wales. It is more common in women aged over 50, and the risk increases with age. Each year, over 2000 women are diagnosed with breast cancer in Wales and around 600 die of it.

If we find breast cancer at an early stage, treatment has the best chance of being successful. The best way of checking for breast cancer is by having regular mammograms, as you may not be able to see or feel early changes. Breast screening has been shown to reduce the risk of dying from breast cancer by around 35%.

3 Does breast screening have any risks?

Any x-ray involves radiation, but mammograms use a very low amount, about the same as a person receives when flying from Cardiff to Australia and back.

You may be falsely reassured by a normal result, and then think that this means there is no risk of developing breast cancer before your next screening test. Screening will miss some cancers, and some cancers will develop between screening. If you notice any changes or have any concerns in between your screening appointments, you should see your GP straightaway rather than waiting for your next routine screening appointment.

Women with possible abnormalities on their mammograms are asked to come back for more checks, which can include x-rays, ultrasound and biopsy (taking samples of the breast tissue). About one woman in every 20 women will be asked back for more checks, but only around one in six of these women could have breast cancer diagnosed. This means that about 40 women out of every 1000 screened will worry about more checks when they do not have breast cancer.

4 How many breast cancers do you find?

We screen around 100,000 women each year. Most are fine, but around 850 women (slightly less than one in 100 women screened) will be found to have breast cancer as a result of breast screening in Wales each year.

Around one in every 1000 women screened will have ductal carcinoma in situ (DCIS). This is when cancer cells are completely contained within the breast ducts and have not spread into the breast tissue or elsewhere in the body. If left untreated, DCIS may develop into invasive breast cancer. Not all DCIS develops into invasive cancer, but it is usually treated once found, as it is impossible to tell which areas would or would not develop into cancer if untreated.

5 Who do you screen?

We invite women aged between 50 and 70 every three years, which is the recommended interval. We identify women from their GP’s lists, so it is important that your doctor always has your correct name and address.

We invite women from each doctor’s practice in turn. You will not necessarily get your invitation in the year that you turn 50. As long as you are registered with a doctor, we will invite you for breast screening before your 53rd birthday.

Women over the age of 70 can ask us for an appointment by getting in touch with their local Breast Test Wales screening centre.

Women aged between 50 and 70 who are being checked again at a hospital breast clinic will still get an invitation from us unless they ask us not to.

We may also send an invitation to women who have had a bilateral mastectomy (both breasts removed) if we have not been told by them or their GP about this.

If you don’t think you should have been invited, please let us know straightaway.

We haven’t yet found routine breast screening for women under 50 to be proved effective.

Whatever age you are, if you are worried about any breast problem, please contact your doctor. They may refer you to the breast clinic of your local hospital.

6 Where do I go for breast screening?

We carry out breast screening in a mobile screening unit or at one of our screening centres. Your invitation letter tells you where to go and how you can change your appointment.

7 What should I wear?

It may be easier to wear a separate top as you will have to undress to the waist. You can wear deodorant if you want as it will not affect the procedure.

8 What will happen?

When you arrive, we will check your personal details and take you to a private changing cubicle. From there, a female radiographer or mammography practitioner will take you to another room for your mammograms. She will explain everything to you and answer any questions that you have. She will then place your breasts, one at a time, between two special plates and take the mammograms.

9 Will the procedure hurt?

Some women find the procedure uncomfortable and a few may find it painful. We need to press your breasts between the two plates to produce good quality mammograms at a low radiation dose. The pressure will only last for a few seconds. If you do experience pain, it usually only lasts for as long as the procedure takes. In a very small number of women, it may last longer.

10 What happens next?

Our specialist staff will check your mammograms. We aim to send you your result by post within three weeks. We will also tell your GP the result.

We then invite women aged between 50 and 70 to come back three years later as part of the screening process.

11 What does it mean if I am called back?

We may need to call you back because of a technical fault. We will tell you if this is the reason.

We call back about one in every 20 women that we screen because the mammogram results show that more tests are needed. These tests may include more mammograms, a clinical examination, an ultrasound scan and possibly a needle biopsy. Most women will not have any problems, or may have harmless breast abnormalities, and we will call them back again in three years as part of the screening process.

12 What if I need treatment?

If you are diagnosed with breast cancer, finding it early gives the best chance of successful treatment. We will fully discuss your options with you and arrange your treatment. You may be asked to take part in a trial to check how effective new treatments are.

13 What happens to my x-rays once they have been checked?

We keep all of your mammograms so that we can do the following

• Compare your latest mammograms with ones you have had before.
• Review all screening records, including mammograms.
• Train and improve the skill level of our specialist staff.
• Measure the quality of the service we provide.

Staff who work in other parts of the health service may need to see your records to help with your medical care. If a review shows that you should have been cared for differently, we will contact you. If you want us to, we will give you more information about your case.

For more information about our records, please contact your local Breast Test Wales screening centre and ask for our leaflet 'How we use information about you.'

14 How accurate is breast screening?

Mammograms are the best way of detecting breast cancer early but they are not perfect. For example:

• some cancers are very difficult to see;
• some cancers, even though they are there, cannot be seen at all; and
• the person reading the mammogram may miss the cancer. (This will happen occasionally, no matter how experienced the reader is.). We aim to have two specialists check all the mammograms.

For every 500 women screened, one life will be saved.

15 What happens if…?

I have not accepted previous invitations, can I still come?

Yes, we would like you to come even if you have not been before.

I have had mammograms elsewhere?

You can still come, as long as the mammogram was more than six months ago. If it was more recent, please contact us.

I have a disability?

Please contact us, even if you have been in the past. You may not be able to use our mobile screening units, but we will try to arrange a reasonable alternative.

I have implants, can I still go for screening?

Yes, but it is more difficult to screen you. The implant is thick and will hide some breast tissue so screening may be less effective. Please contact us as we may need to change your appointment.

I need someone with me?

There is not much space on our mobile units, so please contact us for more information before your appointment.

I need to claim travel expenses?

If you are on Income Support, you can claim your expenses back. Please ask us for a form.

I need an interpreter?

We can normally arrange an interpreter. Please let us know at least a week before you come.

I would like to know about the amount of radiation?

Mammograms use a tiny amount of radiation, and the risk to your health from this is very small. If you are worried about the examination or have any questions, please ask the radiographer.

What about family history?

Only about 5% of breast cancers cases are family-history related. If you are worried about breast cancer running in your family, please see your GP for advice.

16 The facts

To help you decide whether or not to come for breast screening, we have listed the main benefits and drawbacks of screening for breast cancer below.

17 More information and support

If you have any questions about the service you should do one of the following:

• Contact your local Breast Test Wales screening centre.
• Ask your doctor.
• Visit the following websites:
  • www.screeningservices.org.uk/btw
  • www.cancerscreening.nhs.uk
  • www.nhsdirect.nhs.uk

If you would like to comment on our Service please visit http://www.screening services.org/btw/survey/

We can provide this information is other languages, in large print, on audio tape or in Braille.

18 Information on Breast Test Wales locations

If you want to change your appointment time, please contact your Breast Test Wales screening centre.

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