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Who is screened for breast cancer

The NHS breast screening programme uses breast X-rays (mammograms) to screen all women in the UK aged 50 to 70 who are registered with a GP. They are sent an invitation to go for screening every 3 years. Women older than 70 can make their own appointment for screening at their local breast screening unit. In England, the breast screening programme is expanding the screening age from 47 to 73.

Benefits and harms of breast screening

Breast screening can help to find breast cancers very early when they are too small to see or feel. The chance of successful treatment is then very high. Experts estimate that breast screening saves around 1,300 lives each year in the UK. 

But screening can also find cancers that will never grow or develop to cause harm in a person's lifetime. We can't tell the difference between cancers that will be harmful and those that won't. Due to this, some women have treatment for a cancer that won't ever cause them any problem. This is called overdiagnosis and overtreatment.

Women with a higher risk of breast cancer

Some women have a high risk of breast cancer due to a family history of the disease or an inherited faulty gene. These women can be screened from a younger age using MRI scans, mammograms or both, depending on the level of risk. If you think you might be at increased risk of breast cancer, speak to your GP. They can refer you to a genetic specialist, who can assess your risk. 

Breast awareness

Even if you are having mammograms every 3 years you should make sure that you know how your breasts normally look and feel. Many breast cancers are still found by women themselves rather than by screening. If you notice any unusual changes in your breasts, don’t wait until your next mammogram. See your GP straight away.

 

CR PDF Icon You can view and print the quick guides for all the pages in the About breast cancer section.

 

 

What is breast cancer screening

Cancer screening involves testing apparently healthy people for signs that could show that a cancer is developing.

Breast cancer screening uses a test called mammography which involves taking X-rays of the breasts. Screening can help to find breast cancers early, when they are too small to see or feel. These tiny breast cancers are usually easier to treat than larger ones.

 

Who has breast cancer screening

Each year more than 2 million women have breast cancer screening in the UK. The NHS Breast Screening Programme invites all women aged between 50 and 70 for screening every 3 years. You need to be registered with a GP to receive the invitations. 

In England, the screening programme is currently extending the age range to include women from 47 to 73 years old. If you are older than the invitation age range, you can still have screening every 3 years but you won't automatically be invited. To make an appointment, talk to your GP or your local breast screening unit.

If you are younger than 50, your risk of breast cancer is generally very low. Mammograms are more difficult to read in younger women because their breast tissue is denser. So the patterns on the mammogram don't show up as well. There is little evidence to show that regular mammograms for women below the screening age would reduce deaths from breast cancer. 

 

Tests used in breast screening

Breast screening takes 2 X-rays of each breast. The X-rays are called mammograms. 

diagram showing a woman having a mammogram

You have one mammogram from above and one from the side. 

Watch our video and find out about having a mammogram.

 

After the test

You should get your results within 2 weeks. The radiographer can tell you when to expect yours. Most women have a normal reading.

If the results are not clear

If the X-ray is not clear enough or shows any abnormal areas, the clinic staff will call you back for more tests. You may need to have the X-rays taken again.

If you are called back

Around 4 out of 100 women (4%) are called back and this can make them feel very anxious. If you are called back because your mammogram showed an abnormal area, you may have a magnified mammogram. This can show up particular areas of the breasts more clearly. They show the borders of any lump or thickened area and can also show up areas of calcium (calcification). 

Only around 1 in 5 women called back will turn out to have cancer. So out of every 5 women called back, 4 will be fine.

Overall, the breast screening programme finds cancer in about 8 out of every 1,000 women having screening.

 

Benefits of breast screening

Breast cancers found by screening are generally at an early stage. Very early breast cancers are usually easier to treat, may need less treatment, and are more likely to be cured. The current evidence suggests that breast screening reduces the number of deaths from breast cancer by about 1,300 a year in the UK.

Women who are diagnosed with breast cancer at the earliest possible stage have a 9 in 10 chance (90%) of surviving for at least 5 years after diagnosis.

 

Possible harms of breast screening

Although breast cancer screening can find many cancers early it is not perfect. There are some possible risks.

False positives and false negative results

Screening doesn't always find a cancer that is there. So some people with breast cancer will be missed. This is called a false negative result. 

In some women, the test picks up something even though they don't have breast cancer. This is called a false positive result and can lead to anxiety and further tests such as a breast biopsy.

Overdiagnosis and overtreatment

As well as finding cancers that need treating, screening can also pick up some very early breast cancers that will not cause any problems in a woman's lifetime. At the moment it is not possible for doctors or patients to be certain whether a breast cancer will grow quickly and needs treating, or will grow slowly and not cause any harm. So almost all women with breast cancer have surgery to remove the cancer and many also have radiotherapy, hormone therapy and chemotherapy.

Screening can also pick up changes in the lining of the breast ducts called ductal carcinoma in situ. It is not possible to tell whether DCIS will develop into a cancer or not. So, many women with DCIS will also have breast cancer treatments.  

You can read about ductal carcinoma in situ.

Some women who go for breast screening will have treatment for a breast cancer or DCIS that never would have caused them any harm. This is called overdiagnosis or overtreatment. A breast screening review in 2012 found that screening leads to around 4,000 women overdiagnosed in the UK each year.

Exposure to radiation

Each mammogram exposes a woman to small amounts of radiation from the X-rays. But the amount of radiation is very small. For every 10,000 women who have regular 3 yearly breast screening between the ages of 47 and 73, experts estimate that there will be between 3 and 6 extra breast cancers caused by radiation.

 

The balance of benefits and harms

There are 15,500 breast cancers diagnosed through screening in the UK each year. Of these, 4,000 will be overdiagnosed and 1,300 lives are saved.

This means that for every life saved from breast cancer by screening, around 3 women are overdiagnosed.

 

Screening for women at higher risk

Women at higher than average risk of breast cancer due to a family history or an inherited faulty gene can have screening from a younger age. If you think you might be at increased risk, speak to your GP. They can refer you to a genetic specialist, who will be able to assess your risk. Not everyone with a family history of cancer is at increased risk themselves.

If you have a family history of breast cancer

The National Institute for Health and Care Excellence (NICE) now recommends that women who have a moderate or high risk of breast cancer because of their family history should start having screening mammograms every year in their 40's.

A joint NHS and Cancer Research UK study looked into mammography for women in their 40's with a significant family history of breast cancer. It found that yearly mammograms for women at an increased risk meant that breast cancers were diagnosed at an earlier stage and that screening helped to save lives.

If you are younger than 40 and at an increased risk of breast cancer, NICE recommends that you should be offered yearly MRI scans from the age of 30 or 40, depending on your level of risk.

If you have a gene mutation

If you have had tests that show you have a change in a gene (mutation) known to increase the risk of breast cancer, the recommendations are slightly different. NICE recommend yearly MRI scans from 

  • Age 20 for women with a TP53 mutation
  • Age 30 for women with a BRCA1 or BRCA2 mutation 

You can read more about having a family history of breast cancer or an inherited faulty gene.

 

Should I go for breast screening?

It’s important that you have access to enough information about the benefits and harms of breast screening to make the decision about whether to go.

Breast screening impact statement

You can get more information to help you decide from our infographic about breast cancer screening.

It may help you to watch our video about the benefits and harms of breast screening on our page about the 2012 breast screening review.

You can also talk to your own doctor or nurse. Or you can contact the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.

 

Breast awareness

Even if you are having mammograms every 3 years it is important to make sure that you know how your breasts normally look and feel. Many breast cancers are still found by women themselves. Cancers can develop between mammograms. This is known as an interval cancer. 

If you notice any symptoms that could be due to breast cancer don’t wait until your next mammogram. See your GP straight away. 

Read about finding breast cancer early.

 

Related information

You can find detailed information about the UK breast screening programme on the NHS breast screening programme (NHSBSP) website. They have various information resources in different formats that answer questions about breast screening. There is a selection of audio and video resources as well as information and instruction leaflets.

Cancer Research UK has played a big part in funding research into breast cancer screening. You can find out about current breast cancer screening trials on our clinical trials database.

We have detailed information about the findings of the 2012 breast screening review that was funded by Cancer Research UK.

You can find detailed statistical information about breast screening rates in the UK in our local cancer statistics section.

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Updated: 24 November 2014