Once a woman reaches the age of 50,
she will be invited to take part in the National Breast Screening Pro-gramme.
This means having a mammogram, a special kind of breast X-ray, once every
three years. You will be invited until the age of 64, but screening will
be extended to the age of 69 by 2001. If you want to continue to be screened
every three years, you will need to make an appointment by phoning the
screening unit or visiting the screening van when it is in your area.
The aim of the programme is to pick up breast cancer while it is still
small and before it has had a chance to spread.
There are various reasons why women are not normally
screened before the age of 50:
- Breast cancer is less common in younger women.
- Mammography is less likely to detect abnormalities
because young women’s breast tissue is denser than that of
older women.
- There is no evidence that screening women
before they reach 50 is cost-effective.
However, younger women who are thought to be at particularly
high risk of developing the condition for some reason are often offered
screening at an earlier stage in their lives. This is usually mammography
performed more regularly than that in older women, although there is
a study that has started looking at whether a new type of scan (magnetic
resonance imaging) is useful in screening young, high-risk women. In
general, though, screening by regular mammograms is most effective in
preventing death from breast cancer in women over the age of 50.
Women are currently screened every three years in the
UK pro-gramme as this appears to be the ‘best buy’ from a cost-effectiveness
point of view. However, some research suggests that doing it every two
years would pick up more treatable cancers, so anyone who is offered
more frequent mammograms, say at work, should accept.
What happens when you have a mammogram?
You will be asked to undress to the waist and stand
in front of the X-ray machine. The radiographer will then position each
breast in turn between two Perspex plates so that it is compressed and
flattened. A brief pulse of X-rays is then used to take images of each
breast – normally two per breast on the first visit and one or two
on subsequent visits. Some women find the experience uncomfortable, and
a few say that it is painful, but for the majority there’s no more
than minor discomfort. In any case, it’s all over very quickly.
The X-ray film will then be examined and you will be
told the results by your screening centre in around 10 days. A minority
of women will be asked to return for a second mammogram, sometimes because
something has shown up which needs further investigation or sometimes
because of technical difficulties with the original X-ray. Remember that
being recalled does not necessarily mean a diagnosis of cancer. Those
who are recalled do see a doctor who will explain why the further check
is needed.
A mammogram
is a special kind of breast X-ray. |
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What mammograms reveal
Although most women are reasonably happy to go for
a routine mammogram, being asked to go back for a repeat test or further
investigations is likely to make you anxious. This is natural enough,
but it may help to keep the worry under control if you know that it is
still unlikely that you will be found to have a serious problem. The
chart below shows what happens when 10,000 women are screened with breast
X-rays.
Of every 10,000 women screened, only around 55 are found to have cancer
and their chances of successful treatment are greatly improved because
the cancer has been detected at a relatively early stage.
Mammography – the pros and cons
- Just having the test makes you anxious: Yes,
but it doesn’t last long and for the vast majority whose results
are normal the relief makes it all worth while.
- Supposing they miss something: It is very
uncommon for a tumour not to be detected by mammography in women over
50.
- A positive result is worrying and means more
tests: Around one in 100 women screened get a so-called ‘false-positive’
result – this means that an abnormality is found which, after
further investigation, is found not to be cancer.
- The X-rays might be harmful: Modern screening
equipment delivers an extremely low dose of radiation and the chance
that a mammogram could cause a tumour to develop is very small.
- Why suffer the worry and discomfort: On balance,
the negative aspects of having a mammogram are very clearly outweighed
by the real possibility that it could actually save your life. If you
are one of the small minority of women whose mammogram does detect
breast cancer, you will have a much better chance of successful treatment
than if it were undiscovered and left to grow.
In those women who attend for screening, four of every ten women who
would have died of cancer will survive.
Of every 10,000 women given a mammogram, 700 will be recalled
for assessment: 100 of these will have a surgical biopsy, of
whom approximately 45 will be clear and 55 will have cancers
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KEY POINTS<
- All women between the ages of 50 and 64 are currently
invited every three years for breast screening, but by the year 2001
screening will be offered between the ages of 50 and 69
- Four of every ten lives lost to breast cancer
can be prevented in this age group by attending breast screening
- After the age of 69, three-yearly screening is
still recommended but you will need to make your own appointment
- Screening women under the age of 50 has not been
shown to be cost-effective
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