INFORMATION SHEET
Breast Screening for Women at Increased Risk of Breast Cancer after
Radiotherapy for Hodgkin’s Disease
What’s The
Purpose Of Screening?
The purpose of breast screening is to detect
breast cancer as early as possible
by picking up changes to the breast
that often cannot be seen or felt. In the UK, around one in every 9 women
will develop breast cancer at some point in their life-time (i.e. before 90years
old). Women who received radiotherapy which included part of their breast tissue
have a higher risk. Early diagnosis of breast
cancer offers the best chance of a successful recovery. It is not known whether
or not breast screening is effective in women under 50 regardless of their
risk.
X-ray pictures called mammograms are taken of the breast. Two views of each breast are taken at every screening appointment. Women having a mammogram are asked to undress to the waist, so wearing a separate top rather than a dress may be easier. The actual X-ray only takes a few minutes and the level of radiation is very low.
Who can have screening?
In the UK, all women aged 50 to 70 years are automatically invited for screening once every three years by the NHS Breast Screening Programme. Continued three yearly screening up to the age of 70 is available to those who want it.
Why does screening not start until the age of 50?
Research studies have shown that screening significantly reduces deaths from breast cancer in women aged 50-64 who attend for screening. For women under 50 the effectiveness of screening is controversial. Experts in the UK currently believe the disadvantages of screening outweigh the advantages for women in the general population under 50, hence it is not routinely offered.
Why am I being offered screening before I am 50?For younger women who have an increased risk of developing breast cancer on account of their past medical history, the collective view of experts in the UK is currently that the benefits of screening are likely to outweigh the harms. However, it is important to realise that, as yet, there is no strong evidence to prove whether or not breast screening in younger women who received radiotherapy for Hodgkin’s Disease is effective and will reduce deaths from breast cancer.
Yes. We need to know whether screening women at higher risk works.
The Department of Health is planning to set up a national evaluation. For the purposes of this evaluation we need to hold personal information on you to issue regular invitations and to check on the performance of the programme. We take great care to keep your personal details confidential and only share information with people who have a statutory or medical requirement for it, for example your General Practitioner.
We are planning to centralise personal data from everyone involved in this evaluation. The data will be held in a database at the West Midlands Cancer Intelligence Unit which is based in Birmingham. These personal details will remain confidential. Only anonymised details will be released to the research teams involved in the evaluation.
Evaluation of the results will help the National Screening Committee to assess whether or not early screening is beneficial.
How reliable is screening?Mammography is currently the best way of detecting breast cancer early. Early diagnosis offers the best chance of full recovery. Most cases of breast cancer detected early are successfully treated with the modern treatments now available. Screening does not prevent cancer and like most tests it is not perfect:
- Some cancers are very difficult to see on the X-ray
- Some cancers, even though they are there, cannot be seen on the X-ray at all
- The person reading the X-ray may miss the cancer (this will
happen occasionally, no matter how experienced the reader is)
- Around seventy per cent of the cancers found at screening are still small enough to be removed from the breast. This means that the whole breast does not have to be removed.
- Screening will not detect all breast cancers, so some cancers will be missed at screening and some women may be falsely reassured.
- Screening will not prevent breast cancer from developing.
- Approximately one in every 20 women who go for screening will be called back for further investigations. Most of the women who have further tests will turn out not to have cancer. However, women who are called back often find this a very anxious time.
- Each mammogram gives a small dose of radiation. The expert view is that the dose is so small it is unlikely to cause any harm and is at least 1,000 times smaller than the doses given for treatment. However, it is theoretically possible that regular mammography in younger women could actually promote the development of a breast cancer.
- Some women find mammography uncomfortable or painful.
- Some women find MRI claustrophobic.