Breast screening

Breast cancer is the most common cancer affecting women. It can occur at any age but is more common in women over 60, and around one quarter of women diagnosed with breast cancer are younger than 50.

Breast screening, using a mammogram, is the best way to detect breast cancer early. Screening mammograms use low-dose x-rays of the breasts to find cancers that are too small to be felt by you or your doctor. Early detection offers the best chance of successful treatment and recovery. It is also important to get to know the normal look and feel of your breasts, and to see your doctor if you notice anything unusual.

Who is eligible for breast screening?#

Many countries run organised breast screening programs that offer free mammograms to women with no symptoms of breast cancer. Programs usually invite women within a target age range — commonly around 50 to 74 — to have a screening mammogram every two years, and some also include trans and gender-diverse people. Where you live, check the details of your local program, as the exact ages and intervals can vary.

A common pattern is:

• Within the invited age range – you receive an invitation in the mail and can have a free screening mammogram every two years.
• Younger than the invited range (for example, 40 to 49) – you may not be sent an invitation but can still be eligible for a free screen.
• Older than the invited range – you may not be sent an invitation but can still be eligible for a free screen.

If you are outside the eligible age group, ask your doctor for a referral to access mammography at public or private diagnostic imaging services.

You generally cannot be screened through these programs if you:

• have recently been diagnosed with breast cancer
• are pregnant
• are breastfeeding.

If at any age you notice symptoms or unusual breast changes — such as a lump, pain or discharge from the nipple — see your doctor as soon as possible, rather than waiting for a screening appointment.

What if I have breast implants?#

Breast screening is generally safe if you have breast implants (also called breast prostheses), but there may be some risks.

A mammogram may be less effective at detecting cancer in people with implants, because the implants can affect how much breast tissue is visible. It is important to tell the screening service if you have implants, so the radiographer can use special techniques to image breast tissue that might otherwise be hidden. This often requires more x-ray images than for people without implants and may involve a little more radiation exposure, and your appointment will be slightly longer (around 20 minutes).

There is currently no evidence that breast cancer occurs more often in women with implants than in women without them. Radiographers take special care to use minimal compression on an implant. It is highly unlikely, though possible, that this compression could cause or worsen leaking of silicone, or change the shape or texture of the breast.

If you have problems with your implants, consult your doctor first, as the screening service does not investigate or diagnose conditions related to breast implants.

How do I organise my breast screen?#

Book your free appointment with your local screening service. When you book, you will be asked about your medical history and whether you have a family history of breast or ovarian cancer. This information is used to estimate your cancer risk so staff can recommend a screening schedule tailored to you. Screening services are typically staffed by women.

What happens at my breast screen?#

At your appointment you will have a screening mammogram — a low-dose x-ray used to detect cancer at an early stage, before symptoms appear. The image is then examined by a radiologist trained to detect abnormalities.

It is a good idea to wear a skirt or trousers with a top, rather than a dress or a suit, as you will be asked to undress from the waist up. You can usually request a gown that opens at the front.

While the mammogram is taken, each breast is briefly compressed between two flat plates so a clear image can be captured. You may feel some discomfort, but this usually lasts only a few seconds. If you are sensitive or feel pain, tell the radiographer, who will help make the mammogram as comfortable as possible, and you can ask for it to stop at any time.

The mammogram takes about 10 minutes, though you may be asked to wait briefly while the images are processed and checked for quality. There are generally no special aftercare instructions, so you can return to your usual activities afterwards.

What happens after screening?#

Your results will usually be sent to you within 2 to 4 weeks, and also to your doctor if you provided their details.

Sometimes people are asked to come back for further tests because more investigation is needed. If you were screened through a free program, this follow-up is usually done at no cost. Being called back may feel worrying, but most people who are recalled do not have breast cancer. Recalls are more common after a first mammogram, when there are no earlier images to compare with.

The images may also be unclear for other reasons. Things that can make a screening film harder to read include:

• glandular (lumpy) breasts, which are common in younger women
• dense breasts, common in pre-menopausal women
• previous breast surgery or radiation therapy
• breast implants
• movement of the breast during the procedure.

Screening programs generally do not report on breast changes that are not signs of breast cancer — for example, non-cancerous (benign) changes such as cysts, or changes that were present before and are stable.

If you are asked to attend for further assessment, it is important to do so as soon as you can. If you have any concerns, you can contact the service and ask to speak to a nurse counsellor. The assessment team will support you throughout the process.

Further tests may include:

• a breast examination
• further mammograms
• breast ultrasound
• a biopsy.

Most people get their results on the day of their assessment, and a copy is sent to your doctor. If you have a biopsy, results may take up to a week.

What if they find breast cancer?#

If breast cancer is found during screening, it is usually detected at an early stage and can often be treated successfully. The doctors and nurses will explain your findings and what happens next, and will contact your doctor, who will plan your ongoing treatment and care.

Interpreting and support services may be available to help if you are d/Deaf or find it hard to hear or speak on the phone.

Key points#

• Breast cancer is the most common cancer affecting women.
• It can occur at any age, but it is more common in women over 60.
• Early detection offers the best chance of successful treatment and recovery.
• Breast screening is generally safe if you have breast implants, though there may be some risks.
• Your medical and family history is used to estimate your cancer risk so staff can recommend a screening schedule tailored to you.

Where to get help#