Diagnosing Breast Cancer

Mammograms (special breast X-rays) are available on the NHS to all women between the ages of 50 and 64 years. Women between 50 and 64 are invited for screening every three years, and work is in progress to extend this to the age of 70. Because breast cancer screening is a rolling programme (GP surgeries are approached in turn), you may not have your first mammogram at 50, but you will have been called for screening by age 53.

On average, most women start the menopause around the age of 50. Women under 50 aren’t offered routine screening because mammograms aren’t as effective in pre-menopausal women. This is probably because the breast tissue is denser (thicker), so problems are harder to find. The incidence of breast cancer is also lower in women under 50 – the risk increases as you get older.

If you’re under 50 and worried about a breast change or problem, it’s still very important to see your GP. Your GP may refer you to a hospital breast clinic, where you’ll have the same screening tests as are carried out on the screening programme.

Mamograms can identify cancer before a lump can be felt. An X-ray of each breast is taken while the breast is carefully compressed (squashed). Most women find this slightly uncomfortable, but it is only painful for a few. A small number of breast cancers do not show up on X-ray, so it’s important to regularly check your breasts yourself too. This is particularly important if you are over 50 and/or breast cancer runs in your family. See your GP if you notice any breast changes.

If your GP is at all concerned about a breast lump or other breast symptoms, they will refer you to a specialist. If you are referred urgently by your GP, a specialist should see you within two weeks. The specialist will ask some questions and then carry out tests to diagnose or rule out breast cancer. When you receive the results of your mammogram, you may be asked to go to an assessment clinic for some more tests, this does not mean you have breast cancer, it just means there is a 'potential abnormality' and the doctors need to make sure everything is ok.

The tests that you might have at an assessment centre include more mammograms, a breast ultrasound (similar to an X-ray but used to examine soft tissue instead of bone), a needle core biopsy (you are given a local anaesthetic and a small piece of breast tissue is removed using a needle), fine needle aspiration (FNA) cytology (a thin needle is used to remove some breast cells and fluid for examination). Some breast clinics can carry out the tests and give most of the results on the same day. In other hospitals, it may take a couple of weeks.Most people who go to an assessment clinic will not have breast cancer, but may have a benign (non-cancerous) condition that can be treated and monitored. Although most breast lumps are not cancer, if the results show that the lump is cancer, some other tests may be needed to see if the cancer has spread.

The amount of radiation used in mammograms is low (the same as flying to Australia and back from the UK) and amounts are constantly monitored to make sure they are as low as possible whilst still being effective and producing reliable results.

If you have any worries about going for a mammography, or what the results of your mammography mean, you should talk to you GP who will be happy to answer any questions you may have.