Current statistics predict one in eight women will be diagnosed with breast cancer during their lifetime. Apart from gender, age is the biggest risk factor of breast cancer and many countries have therefore set up screening programmes inviting women of a certain age to have a routine screening mammogram. Mammogram screening is not a perfect intervention, but many clinicians agree that it does promote the detection of early, symptomless breast cancer, when treatment is often most successful.
What are mammograms?
Mammograms are specialised screening X-ray machines that can be used to detect changes caused by breast cancer that would otherwise go unnoticed until the cancer progresses to later stages. The aim of mammogram screening is to find a cancer in women who would not normally show physical symptoms, such as a palpable lump or a change in breast appearance.
Who is invited to attend mammogram screenings?
The biggest age group affected by breast cancer are those aged 60 to 64 with nearly four out of five diagnoses made in women over the age of 50. In the UK, the NHS Breast Screening Programme is in place to determine how often women should get mammograms. With this scheme invitations are sent out to all women with a registered GP aged between 50 and 70. In some areas this extends to those aged between 47 and 70.
Women at higher risk
Those placed in a high-risk category of breast cancer may be advised to undergo screenings more regularly and starting from an earlier age. An increased risk can be due to close family or personal history of breast or ovarian cancer, significant exposure to chest radiation or those with a genetic mutation known to significantly increase your risk of breast cancer. If you feel you may be at increased risk you can speak to your GP who may refer you to a specialist to assess your personal risk. According to guidelines set by the National Institute for Health and Care Excellence (NICE) women should attend the following screenings based on their risk.
- Low risk - Routine mammograms carried out every three years between the ages of 50 and 70 (or 47 and 73 depending on your area)
- Moderate to high risk - Routine yearly mammograms from the age of 40
- High risk - For women under the age of 40, yearly MRI scans starting at 30
- Significantly increased risk - Yearly MRI scans from the age of 20 for those carrying the TP53 mutation and from the age of 30 for women carrying the BRCA1/2 mutation.
The breast tissue of premenopausal women under 40 is much denser and therefore harder to read from a mammogram. This increases the chance of false-positive results and so screening is often also carried out by MRI or ultrasound scans.
What does it mean if I am called back?
Dr Emma Pennery, clinical director of Breast Cancer Care, assures women that being called back for further tests isn't something to worry about. "A recall does not necessarily mean you have cancer. It may mean doctors want to investigate further, or that the mammogram wasn't clear enough and you need another one." Overdiagnosis is a common term used when referring to screening methods. This accounts for the number of patients who go through unnecessary treatment based on the detection of a pre-cancerous or cancerous lump that would have gone unnoticed should a screening mammogram not have taken place. Research is still needed to identify and differentiate those lumps that are threatening from those that pose no health risk. However, at this point there is no definite way of knowing when a lump can turn into a lethal, life-threatening cancer. Until we get to this stage, regular screening mammograms are thought to be vital in reducing the mortality rate of breast cancer patients.
"There are risks as well as benefits to having a mammogram, so you should be well informed about the test before you consider having it done" says Dr. Wendy Snell, MBBS DCH DGM FPC DRCOG Dip Occ MSc OH, General Practitioner, Blossoms Healthcare. "There are lots of different views about how often you should consider having a mammogram and the best thing to do is to discuss things with a clinician before deciding upon what's right for you as an individual".
Can I opt out of mammograms?
The scheduled mammograms are in no way compulsory and around 25% of women choose to opt out of them by simply ignoring their invitation. However, mammograms do provide a way to find breast cancer in its earliest stages and when treatment outcomes are usually more successful.
When it comes to early detection of breast cancer, being 'breast aware' and carrying out regular self-examinations are just as important as mammogram screenings. "Prompt detection of breast cancer can lead to more effective outcomes," highlights Dr Pennery. "We encourage all women to be breast aware. Spot and report any unusual changes to their GP immediately."
Please note this is a sponsored article which has been published in association with Blossoms Healthcare.