BREAST SCREENING

by Mrs Julietta Patnick, National Co-ordinator, NHSBSP

The NHS Breast Screening Programme in the United Kingdom was set up following the report of a working party chaired by Professor Sir Patrick Forrest in 1986.This report recommended breast screening by mammography every 3 years to all women aged 50-64 with screening for older women being available at their request.

Aged Between 50-64?

If you are aged between 50-64 you shall receive an appointment for a mammogram when the service is covering the area where you live.As each area is screened in turn over a period of 3 years some women may be 51 or 52 years old when first invited for screening.Thereafter screening shall continue over regular three yearly periods.Your screening mammogram shall be carried out either at your local hospital or on a mobile mammography unit depending on the area where you live.

Aged Over 64?

If you are over 64 years of age,you need to ring your local Breast Screening Unit for an appointment. At your request you shall receive an appointment for a mammogram and this will be carried out at the Hospital or on a mobile mammography unit. All those over 64 years of age are welcome to have mammograms but no routine invitations are sent out.

Aged Under 50?

If you are aged 40-41 you may be randomly selected to have yearly mammograms until the age of 49 after which you shall join the NHS Breast Screening Programme. This is part of a nationwide trial to assess the effectiveness of breast cancer screening in women aged 40-49.

The Mammogram

The screening mammogram is an X-ray of the breast taken by a trained radiographer by compressing the breast between two plates for a few seconds under an X-ray machine.The mammogram is subsequently reported by the Consultant Radiologist.The whole procedure takes only a few minutes and the discomfort experienced occasionally is due to compressing the breasts between the plates which passes away soon after.If you have already had a mammogram before and found the procedure painful please inform the radiographer.You need to undress to the waist for a mammogram so wearing a skirt or trousers helps.

Mammography does not detect all breast cancers but is the most effective method of screening for breast cancer.

Your Results

After you have had your mammogram,the films are reported by a Consultant Radiologist specialised in the reporting of mammograms.The majority of women receive their results in three weeks.The result is one of:

1. NORMAL
2. TECHNICAL RECALL
3. RECALL TO ASSESSMENT CLINIC

Normal

A majority of the mammograms are reported as NORMAL and you shall receive a letter explaining this within three weeks.This letter also explains that you shall be called back for another screening mammogram after three years.If you are going to be over 64 years of age in three years time instructions on how you can arrange your mammogram are included.

Technical recall

Rarely you may be called back for repeat mammograms due to a technical problem as the films do not meet the minimum standards.This occurs in less than 2% of all women who have mammograms.Please remember you are being called back as there is a problem with the films and not your breasts.

Recall to assessment

1. Clinical examination,
2. More X-Ray views of the breast,
3. Ultrasonography
4. Needle tests for tissue diagnosis (FNAC or CORE)

At the end of this assessment 85% of all women recalled are normal and returned to routine three yearly mammograms.

The assessment process takes between 30 minutes to an hour, hence it is advisable to take somebody along with you.In a majority of cases the result shall be given at the same visit.If you have had a needle test you shall be called back for the results 3 to 7 days later.Rarely the material from the needle test may not be adequate for the cytopathologist to give a definite diagnosis.In this case you may need to have repeat tests.

If you are concerned about any issues prior to attending the assessment clinic please telephone your local breast screening unit.