If you are approaching your 50th birthday you may soon receive your first invitation for a breast screening check known as a mammogram. You may not know what to expect?
Women in the UK are invited for breast screening between the ages of 50 and 70 years every 3 years. (In some areas it is between 47 and 73 years.) These invitations are continuing during the ongoing Coronavirus epidemic, because picking up cancer early can save lives and the breast screening departments within hospitals can be made as safe as possible, with all staff wearing PPE and the equipment regularly cleaned and sanitised.
If you are from an Ashkenazi Jewish family, it may be more important for you to attend your breast screening appointments. This is because breast cancer is more common in our community. This is especially the case if you have a strong family history of breast cancer or the ‘related’ cancer of the ovaries, when it is possible that your genes might increase your risk. If so, it is worth asking your doctor about a possible referral to a family history clinic where they can look into whether your genes might raise your cancer risk.
The beauty of mammography is that it may pick up a very small breast lump which you might not have felt or noticed. The outcome for early diagnosis of breast cancer is very good e.g. 90-98% 5 year survival. (This is the normal way in which the success of cancer treatments is measured. It means that 5 years after treatment 90-98% of those ladies treated for breast cancer, which was picked up early, are still alive. The majority of these will go on to live a full and long life.) Most women feel scared if they are told that they have any kind of cancer however diagnosis and treatment for breast cancer have improved so much that survival rates have doubled in the UK in the last 40 years. Breast screening is one of the reasons for this improvement. In my GP surgery I often saw women who had been treated for breast cancer many years beforehand and had fully recovered.
The breast screening units are staffed only by women. Each breast is in turn positioned on the box-shaped mammogram machine and a plastic plate is lowered, which flattens out the breast tissue for a few seconds while X-rays are taken. This is safe and will not damage your breasts but can be briefly uncomfortable.
How soon will you hear back from the service? This is usually quick: about 2-3 weeks and for most women it will be good news, with a normal result. Try not to be worried if you receive a recall letter to say that appointment is needed. 3 out of 4 women who are recalled will NOT be found to have cancer. Often, all that is needed is a further X-ray from a different angle because the first X-ray picture wasn’t clear enough. A scan or perhaps a needle biopsy might be suggested. If there is a biopsy, a small sample of breast tissue is taken with a needle, while you are awake in the clinic, to be later examined under a microscope. This can feel sore but again is quick and tolerable (a little like the short discomfort of having your ears pierced.) This time the results usually take 1-2 weeks.
Unfortunately, the Coronavirus epidemic has meant that there have been delays in cancer screening programmes and sometimes in treatment also, especially because the time between appointments is longer to allow for extra cleaning of the room and equipment. This should be a temporary situation. Great efforts are being made to try to overcome these delays.
It is vital that you attend when called for screening, even though only about 1 in 100 women screened overall will be found to have breast cancer they will be offered prompt treatment. However, some women will have breast cancer picked up and treated which might never have caused harm if left untreated because it is very slowly growing. In the future it will become easier to detect which cancers can be left safely alone. Like all hospital tests, mammography is not perfect but it is very accurate. Only about 1 in 2,500 women might have a diagnosis of breast cancer missed. If in between mammograms you get any new symptoms, please don’t ignore them or delay seeing your doctor. They will want to see you as soon as possible for an opportunity to arrange further tests.
I am speaking from personal experience when I recommend breast screening. I have had a few mammograms over the years. I have always felt a little apprehensive but been reassured by the calm and professional atmosphere in the clinics. I have found the mammograms uncomfortable but never been put off by this. I have even had a couple of biopsies. This experience has left me feeling reassured and grateful for the availability of such a service.
What about older women? You have the important option to request to continue to have mammograms after age 70 years. To arrange this, you need to contact your local breast screening service and continue to contact them every 3 years.Dr Jackie Rose has written ‘To Life! Healthy Jewish Food’ together with her cousin Judi Rose (the daughter of Evelyn Rose)
Dr Jackie Rose (Lewis) is co-author of ‘To Life! Healthy Jewish Food’ together with Judi Rose, daughter of the late Evelyn Rose. She also works voluntarily as co-chair of Salford Healthy Communities and as a GP/ nutritionist for Private GP Extra.