Breast screening frequently asked questions

We answer some of your most commonly-asked questions on breast screening and breast cancer.

Hand holding breast cancer ribbon

What is a mammogram (breast screening?)

Breast screening is a test designed to detect breast abnormalities in women before they are aware of a lump or any other symptom. Early detection significantly increases survival and is associated with less extensive treatment.

The only universally accepted and effective method of breast screening for normal-risk women over the age of 40 is by the use of an x-ray test called a mammogram. This requires a low dose of radiation, approximately the same as the radiation all people are exposed to by taking a return transatlantic flight.

At OneWelbeck we use digital mammography, which produces better quality images, particularly for younger women with denser breasts. With more densely glandular and fibrous breasts, sometimes a special type of digital mammography called tomosynthesis may be used at the discretion of the consultant radiologist. This produces 3D images of breast tissue which may be helpful for diagnosis in some cases.

Who can have screening with digital mammography?

At OneWelbeck we offer routine breast screening to all women age 40 and above in accordance with the American Cancer Society. We do not offer routine breast screening for women under 40 years of age as the benefits are less clear at a younger age, and the limitations or potential risks are higher.

What are the benefits of a mammogram?

Screening does not prevent cancer, but lives are saved and breast tissue can be conserved as screening can find cancer at an early stage when it is too small to see or feel. Breast cancers detected by screening tend to be smaller, with better prognostic features such as a lower grade of malignancy and less likelihood of lymph node involvement. This reduces the requirement for a mastectomy to half the number of cases compared to women whose breast cancers are found because of a lump or other symptoms.

Screening women between the ages of 40 and 49 will reduce the chance of a woman dying from breast cancer by 25% and annual screening after the age of 50 can reduce the chance of dying from breast cancer by 25-30%. Breast screening now saves 1,300 lives every year in the UK.

What are the limitations and risks of a mammogram?

Breast screening picks up most breast cancers but it misses breast cancer in about 1 in 2,500 women screened. This can happen no matter how well trained and skilled the doctors (consultant radiologists) reading mammograms are.

Some women will be diagnosed and treated for cancer that would never have otherwise have been found and would not have become life threatening. This is referred to as overtreatment and is the main risk of screening. Unfortunately it is not possible with the current state of scientific knowledge to make a judgement as to whether some cancers could be left with little or no treatment once diagnosed.

At the present time all breast cancers discovered are treated according to established protocols while research continues to work out treatment pathways, which in future may be decided by individual tumour genetic and molecular make up.

Sometimes a mammogram will not look normal and you will be asked to undergo tests such as a needle biopsy but cancer is not there. This is called a false positive result. Sometimes a mammogram will look normal, even if a cancer is there. This is called a false negative result. You should remain breast aware and always report any significant symptom such as a new lump, skin dimpling or bloody nipple discharge.

X-rays can very rarely cause cancer. Having regular screening appointments can be life-saving and is far more likely to detect cancer than cause a tumour.

What will happen during my visit?

When going for breast screening you will only be asked to undress from the waist up. A female radiographer who takes your mammogram will ask you about any breast problems, explain the procedure and will be available for you to ask any questions. Your breast screening visit should take about half an hour.

Many women find having a mammogram temporarily uncomfortable. A few may find it painful, but only for a few seconds. The mammographer will place one breast at a time between two special plates on the mammogram machine. She will take two or more images of each breast. Your breast needs to be pressed gently but firmly between the plates for a few seconds to help keep you still and get clear images, this also reduces the amount of radiation the breast receives.

How do I get my results?

Consultant radiologists will review all the digital mammograms. Your mammographer will discuss with you when your results will be sent to your GP or referring doctor.

Most women’s mammograms will show no sign of cancer. However, cancer can still develop between mammograms so it is important to be breast aware and inform your GP straight away if you notice any breast changes.

Sometimes technical problems mean that the mammogram is not clear enough to read. If this happens, you will be asked to have another mammogram to get a clearer picture.

Approximately 1 in 10 women will require further tests after screening. OneWelbeck offers rapid access to expert advice and further tests where clinically appropriate, including further mammograms, an ultrasound scan or a needle biopsy. If you would like to know more about these further tests prior to screening, please ask your consultant, mammographer or breast care nurse.

Why is breast awareness important?

Breast awareness is an important part of caring for your body. If you get to know how your breasts normally look and feel you will be more likely to spot any changes that could be signs of breast cancer. This is important even if you have been for breast screening. Look out for the following:

  • A lump or thickening in the breast.
  • A change in the nipple. The nipple might be pulled back into the breast or change shape. You might have a rash that makes the nipple look red and scaly, or have blood or another fluid coming from the nipple.
  • A change in how the breast feels or looks. It may feel heavy, warm or uneven, or the skin may look dimpled. The size and the shape of the breast may change.
  • Pain or discomfort in the breast or armpit.

If you have any change to your breast, you should make an appointment to see your doctor straight away. You may not have cancer, but if you do, being diagnosed and treated at an early stage may mean that you are more likely to survive breast cancer.

Mammographers will always be happy to discuss breast awareness in more detail should you like further information.