What happens when your breasts get checked out...
Breast screening reduces the number of deaths from breast cancer by about 1,300 a year across the UK. Here, outlines exactly what happens both during and after the tests are carried out...
Breast cancer now affects one in nine women in Wales at some point in their lives. But if caught early enough, the chances of surviving it are better than nearly all other forms of the disease.
The Welsh NHS offers screening to all women aged between 50 and 70 every three years in an attempt to spot the cancer before symptoms show.
Here, we explain exactly what happens during a breast screening session, so women can feel more prepared ahead of the appointment.
Who has breast screening? Women between the ages of 50 and 70, who are registered with a GP, will be invited for a screening every three years by Breast Test Wales.
Those over 70 can still have screening every three years, but won’t be invited automatically.
Similarly, those under 50 are not invited, as the risk of developing breast cancer increases later in life. The tests, known as mammograms, are also more difficult to read in younger women because their breast tissue is denser.
However, some women at an increased risk of breast cancer (due to a family history of the disease, for example) may benefit from screening at an earlier age.
But, no matter how old you are, if you are worried about a breast problem you should contact your GP, who may refer you to the breast clinic at your nearest hospital.
A spokeswoman from Breast Test Wales said: “We invite each doctor’s practice in turn. You will not necessarily get your invitation in the year that you turn 50. As long as you are registered with a doctor, we will invite you for breast screening before your 53rd birthday.”
What happens during the screening?
Breast screening uses a test called mammography, which involves taking x-rays of the breasts. The test helps to find breast cancers when they are too small to see or feel.
There are no special preparations for a mammogram, so women can eat and drink normally beforehand.
A radiographer will then ask the patient to stand close to the x-ray machine. They will then position one breast at a time between two flat plates on the machine.
The plates press the breast firmly between them for a few moments, which might be uncomfortable.
Two x-rays are taken of each breast: one from the top and one from the side.
What happens after the mammogram?
The patient can get dressed and go home straight after the mammogram. They might have some tenderness in the breasts for up to a few hours.
Two people, called film readers, image readers or radiologists, then look at the mammogram pictures. Around 96 out of 100 women in the breast screening programme have a normal result.
If the X-ray isn’t clear enough, or shows any abnormal areas, the clinic staff will call the patient back for more tests. The mammograms might need to be taken again in some cases.
What does a mammogram show? With early stage breast cancer there might not be a lump, but the mammogram may show small areas of calcium in the breast tissue.
These areas of calcium are called calcification. Calcification also develops because of non-cancerous changes in the breast.
The skill and experience of the technicians and doctors helps them to read the different patterns and decide which might be related to cancer and need further tests.
Some people have a condition called ductal carcinoma in situ (DCIS) that shows up on the mammogram. DCIS means that some cells in the lining of the ducts of the breast tissue have started to turn into cancer cells.
Is there a risk of developing cancer from radiation?
The mammogram involves passing very small amounts of radiation through the breast tissue to form a picture.
Even though radiation can cause cancer, the risk from mammography is described as “very low”, with the benefit far outweighing the radiation risk.
The Breast Test Wales spokeswoman added: “The number of lives saved by detecting and treating breast cancer is much greater than the number of lives that may be lost because of cancer caused by radiation.”
The amount of radiation is referred to as the “dose”. The lower the dose, the smaller the risk.
However, if the dose is too low, the mammogram may not be clear enough to show whether cancer is present.
“We monitor our equipment to ensure that the correct balance is struck between the dose and the quality of the mammogram,” the spokeswoman added.
The lifetime risk of a mammogram causing cancer in a typical 60-yearold woman is about 44 per million, or one in 23,000.
When are the results given to the patient?
Women usually receive a letter with the results within three weeks of having the test.
Occasionally, Breast Test Wales says screening results take longer than three weeks, due to delays in the mammogram being read, for example.
Approximately one woman in every 20 is asked to come back for more tests. These tests may include more mammograms, a clinical examination, an ultrasound scan and possibly a needle biopsy.
What is the survival rate for breast cancer?
When it comes to one-year and fiveyear survival rates, breast cancer fares very well.
Between 2010 and 2014, 95% of breast cancer patients survived for a year or more, and 83.8% survived five years or longer.