The Na­tional Breast Screen­ing Pro­gramme

Malta Independent - - NEWS - Stephanie Xuereb Dr. Stephanie Xuereb is a Con­sul­tant at the Pub­lic Health Medicine within Na­tional Screen­ing Pro­grammes

The pri­mary aim of a breast screen­ing pro­gramme is to re­duce both the mor­tal­ity and mor­bid­ity from breast can­cer through early de­tec­tion and treat­ment of breast can­cer in women who as yet do not have any symp­toms of breast can­cer.

The Na­tional Screen­ing Pro­gramme is a ser­vice ded­i­cated to nor­mal healthy women who are breast aware and would like to take con­trol over their well be­ing.

Since the com­mence­ment of this pro­gramme in 2009, over 90,000 women have been in­vited to par­tic­i­pate in the screen­ing pro­gramme and over 350 cases of breast can­cer have been picked up. Over the years the Na­tional Screen­ing Pro­gramme has been grad­u­ally ex­panded so that it is now of­fered to all women be­tween the ages of 50-66 years of age.

The World Health Or­gan­i­sa­tion’s In­ter­na­tional Agency for Re­search on Can­cer (IARC) re­ports that women 50-69 years of age who at­tended mam­mog­ra­phy screen­ing, had a re­duc­tion of breast can­cer mor­tal­ity of around 40%.

The main ob­jec­tive of the Breast Screen­ing Pro­gramme is to find and be able to cure breast can­cer at the ear­li­est pos­si­ble stage. This ser­vice pro­vides free breast screen­ing through mam­mog­ra­phy ev­ery three years. Women re­ceive an in­vi­ta­tion by post which in­cludes an ap­point­ment for a mam­mo­gram at our unit at Las­caris Wharf, Val­letta. Should the date or time not be con­ve­nient for our clients, they are strongly en­cour­aged to con­tact our of­fices to change the ap­point­ment time.

The mam­mo­gram is a sim­ple test which in­volves tak­ing two views of each breast, one from above and one from the side of the breast. The pro­ce­dure takes only a few min­utes to com­plete and is car­ried out by fe­male ra­dio­g­ra­phers which are specif­i­cally trained in breast screen­ing. The mam­mo­grams are then in­de­pen­dently read by two dif­fer­ent ra­di­ol­o­gists. The mam­mo­gram can de­tect small changes in the breast tis­sue which can in­di­cate can­cers which are too small to be felt on clin­i­cal ex­am­i­na­tion of the breast.

In the ma­jor­ity of cases, no more tests are re­quired and the re­sult is sent by post and clients are in­vited to par­tic­i­pate once again af­ter three years. A small num­ber of women would re­quire fur­ther as­sess­ment and are re­called for more tests, such as ul­tra­sound or biopsy.

It is im­por­tant that women re­ceive a bal­anced view of in­for­ma­tion about breast can­cer screen­ing. Some women find screen­ing un­com­fort­able or even painful, but this is only for a few min­utes dur­ing the test. All X-rays, in­clud­ing mam­mo­grams, in­volve hav­ing a small de­gree of ra­di­a­tion. The amount of ra­di­a­tion given dur­ing a mam­mo­gram is very small and un­likely to cause harm. The ra­di­a­tion risk as­so­ci­ated with hav­ing a mam­mo­gram ev­ery three years is min­i­mal and the ben­e­fits of screen­ing and de­tect­ing a breast can­cer at an early stage when it is more likely to be cur­able far out­weigh the risk. Through reg­u­lar qual­ity as­sur­ance of our ra­di­ol­ogy sys­tem, the ra­di­a­tion dose given by the breast screen­ing X-Rays is con­tin­u­ously mon­i­tored to make sure that it is as low as pos­si­ble whilst still giv­ing a high qual­ity im­age.

Screen­ing alone does not re­sult in de­creased mor­tal­ity but timely ac­cess to treat­ment as well as im­prove­ments in treat­ment and ser­vice de­liv­ery are cru­cial to im­proved sur­vival.

In the ma­jor­ity of cases, no more tests are re­quired and the re­sult is sent by post and clients are in­vited to par­tic­i­pate once again af­ter three years. A small num­ber of women would re­quire fur­ther as­sess­ment and are re­called for more tests, such as ul­tra­sound or biopsy.

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