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Breast screening certainly saves lives. It helps to diagnose breast cancer early, which we know improves the outcome of treatment. But is regular screening doing more harm than good? There’s varying opinion about breast screening – even among the experts – and this can be confusing for women who just want to do the best for their health.
There’s been lots of talk in the media about the risks of breast screening – overdiagnosis, false-positive results, unnecessary cancer treatment and the risk of radiation. But there’s also the fact that around 1,300 breast cancer deaths are prevented every year in the UK thanks to breast screening.* So, in this blog, we’re laying out the benefits and risks of breast screening. Whether or not to have screening is up to you – it can help to find out as much as you can to help decide.
What is breast screening?
Breast screening is a way of finding breast cancers early, when they are too small for you or your doctor to see or feel. The test used for breast screening is a mammogram, which is a breast x-ray. It involves having each breast, in turn, gently but firmly compressed (squashed) with a flat, clear, plastic plate. An x-ray is then taken to get a picture of your breast tissue. Most women find this uncomfortable and some say it’s painful, but it doesn’t take long, and you can go about your normal day again afterwards.
What is the NHS Breast Screening Programme?
Under the NHS screening programme, all women registered with a GP and aged 50–70 are offered a mammogram every three years. If you’re over 70, you won’t get invitations any more, but you can still have a mammogram every three years.
Each year, more than one and a half million women in the UK have breast cancer screening as part of the NHS Breast Screening Programme.
What are the benefits?
What are the risks?
While breast screening certainly saves lives, for every life saved, about three women will have treatment for a cancer that would not have caused them problems.*****
Independent Breast Screening Review 2012
In response to all the questions about the effectiveness of breast screening and whether women are being given the right information about it, Cancer Research UK worked with the National Cancer Director to set up an independent review of breast screening. Experts weighed up all the evidence about the pros and cons of breast screening. The panel included a breast cancer patient and experts in medical statistics, research and breast cancer treatment.
The Panel concluded that screening reduces breast cancer deaths but at the cost of overdiagnosis. The Panel also concluded that the UK breast screening programme has significant benefit and should continue.
You can read more about the review on Cancer Research UK’s website.
Making decisions about screening
Deciding whether or not to have breast screening isn’t easy, but we hope the information in this blog helps you to weight it all up.
For more information, you may want to order our free booklet, Understanding breast screening.
Breast screening can't pick up every cancer, so you should see your GP if you have any symptoms such as a change in the size or shape of your breast, a breast lump, pain or discharge from the nipples. You should see your GP even if you are having regular breast screening and have recently had a normal mammogram.
And remember, if you ever need to talk or ask a question, our cancer support specialists are here.
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*Findings of the Independent Breast Screening Review, by Cancer Research UK and the National Cancer Director, 2012. http://www.cancerresearchuk.org/cancer-help/about-cancer/cancer-questions/what-the-breast-screening-review-means#found** Gøtzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Summaries. 2011. http://summaries.cochrane.org/CD001877/screening-for-breast-cancer-with-mammography***Benefits of breast screening. Macmillan Cancer Support. http://www.macmillan.org.uk/Cancerinformation/Testsscreening/Breastscreening/Benefits.aspx#DynamicJumpMenuManager_6_Anchor_3 ****Disadvantages and risks of breast screening. Macmillan Cancer Support. http://www.macmillan.org.uk/Cancerinformation/Testsscreening/Breastscreening/Difficulties.aspx#DynamicJumpMenuManager_6_Anchor_4 ***** Findings of the Independent Breast Screening Review, by Cancer Research UK and the National Cancer Director, 2012. http://www.cancerresearchuk.org/cancer-help/about-cancer/cancer-questions/what-the-breast-screening-review-means#found
This is a difficult decision to make for many. If you follow through from a decision to screen, you then realise that you could be diagnosed and treated but be one of the 3 out of 4 women (people?) that are treated for cancers that would not cause them harm (from the research). Any treatment has side effects and these can be severe and life changing for cancer. It can take years to be able to work again or enjoy life. I believe the impact can also affect your long term health eg cardiovascular disease (see Macmillan's report on routes to diagnosis).
If you are unlucky enough to be diagnosed, when you are frightened and in shock, as many are, it can be a difficult and awful time to decide what to do for the best. Consultants and oncologists will usually consider the medical impacts on the cancer itself and it often feels as if you are just a lesion in their eyes. It is meant for the best, but may not reflect your needs. All of this depends on how much you are able to know about your cancer and at the beginning this is not a lot.
The recent increase in the screening age range for breast cancer has as part of the implementation a responsibility for the cancer team specialists to explain more fully to the patient what the outcomes and long term effects may be.
I hope in future breast cancer will be seen with less fear as it becomes a more managed disease.
Did I read right, that out of 100 women who are screened, 3 will end up getting a diagnosis and surgery who would never have needed it?
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