Breast cancer is the UK’s most common cancer with nearly 48,000 people diagnosed every year. However, the positive news is that deaths due to breast cancer are falling sharply. There are several different factors accounting for this fall, including earlier detection through screening and a range of improved treatments.
Statistics show the number of new breast cancer cases diagnosed does increase with age. This means the disease is unusual under the age of 40 and women between the ages of 40 and 50 are less likely to develop breast cancer than those aged 50 and over. While this is the case, many women choose to have screening earlier than the NHS Breast Screening Programme which starts from the age of 47.
Carol Wallace, Wellwomen Sister answers your questions:
Does a family history of breast cancer put you more at risk?
Research has indicated that while in some families a history of breast cancer may increase your risk, the increase in risk is only significant in those who are generally pre-disposed. There is no proven benefit for mammography under the age of 40.
What is a mammogram?
A mammogram is an x-ray examination of the breast and is an effective means of detecting or investigating breast disease. It is used particularly to diagnose small breast cancers and can detect a change in the breast tissue before you can feel or notice anything unusual. It can also show small deposits of calcium in the breast, which may be a sign of early cancer or changes that may lead to cancer.
Who is offered a mammogram?
Population screening is an effective method of reducing the death rate from breast cancer in women over the age of 40. This reduction may be as high as 40-50 percent in those who are screened regularly.
There are difficulties in screening younger women, as the breast tissue tends to be denser which can make reading mammograms more difficult. The NHS Breast Screening Programme provides screening for all women aged 47 to 73 every three years. Bupa recommends mammography from the age of 40 onwards.
The most appropriate frequency for mammograms is every two years for most women over the age of 50. However, annual mammography is recommended for women aged 40-49. Mammography should not be performed more frequently than every 12 months unless recommended by a breast specialist.
What are the radiation risks?
The risk of cancer from mammography is very low. General opinion and research suggests that overall the benefit of regular mammography greatly outweighs any small risk.
What are the benefits?
Mammography can detect cancers that may be too small to feel, but are visible on high quality films read by a specialist radiologist.
If the cancer is detected when it is small and has not had a chance to spread there is a greater chance of successful treatment than if detected later at a more advanced stage. The benefit of screening women from 40 is thought to significantly outweigh the potential risk.
What can I expect when the mammogram is taken?
The mammogram is always taken by a specially trained female radiographer. Two x-rays will be taken of each breast, which will be compressed between an x-ray film and a perspex plate, so all the breast tissue can be seen clearly, and to prevent any movement. This examination may be uncomfortable for a few seconds but is usually well tolerated by most women. Some women may experience reddening of the skin and occasionally tenderness for a short time afterwards.
What if an abnormality is detected?
Not all abnormalities on a mammogram are due to cancer. The majority of abnormalities are due to benign conditions. Following a routine mammogram, a proportion of women may need further assessment in a specialist breast clinic.
The aim of this is to clearly distinguish between those x-ray changes which are benign and harmless, and those which may need further treatment. This further assessment may involve investigations such as additional mammograms, ultrasound, and a clinical examination by a specialist.
In some cases a sample of tissue may need to be taken, normally under local anaesthetic using a small needle.
Remember, further assessment doesn’t necessarily mean you have cancer. In fact, most women who undergo further investigation do not have cancer.
Can I still have a mammogram if I have breast implants?
If you have breast implants we can still perform a mammogram. However, because the implant may mask some areas of the breast, the mammogram will be less sensitive at picking up early changes, and it may be more difficult to see abnormalities.
Women who have had a breast implant should still have regular mammograms and be “breast aware” by knowing what your breasts feel like when you shower and carry out other day to day activities.
If I have just had a baby do I need to wait until I stop breast feeding before I have a mammogram?
A mammogram cannot be performed while you are breast feeding, or for six months after you have stopped breast feeding. This is because there are changes in the breast that make interpretation of the x-ray films less reliable.
Why choose a Breast Check?
Early detection hugely improves your chances of getting better - breast cancer death rates have fallen by a fifth in the last ten years.
Bupa’s Breast Health Check consists of a thorough breast examination, including a mammogram if you're over 40, to help detect early signs of breast disease. You will have plenty of time (up to 30 minutes) to talk to our expert Wellwoman Sister about your background and lifestyle during your personalised consultation. The Sister will also give you advice about how to be breast aware, and you will receive your results as quickly as possible.
Bupa Health and Wellbeing is based at Spire Norwich Hospital. For more information call us on 01603 505011, or visit www.bupa.co.uk/wellness
The content of this page is provided for general information only. It should not be treated as a substitute for the professional medical advice of your doctor or other healthcare professional.