Breast Screening

The UK breast screening programme

Breast cancer is the most common type of cancer in the UK and 1 in 8 women in the UK develop breast cancer during their lifetime (Cancer Research UK 2015). Breast screening is a method of detecting breast cancer at a very early stage, which involves taking an x-ray - a mammogram - of each breast. The mammogram can detect small changes in breast tissue which may indicate cancers that are too small to be felt either by the woman herself or by a doctor.

The National Health Service Breast Screening Programme (NHSBSP) was set up in 1988. Women between the ages of 50 and 70 are routinely invited for free screening every three years. In some areas, women aged 47 to 49 and 71 to 73 also receive invitations for screening. This is part of a study looking at whether to extend the breast screening age range. Screening is for all well women without symptoms, whether they have a family history of breast cancer or not.

Breast screening is an important way to detect cancer early and around a third of breast cancers are diagnosed through screening (according to The Department of Health's Improving Outcomes: A Strategy for Cancer - January 2011). It is not the only way breast cancer is detected, though, and it is important women be 'breast aware' (check their breasts regularly).

Any woman who is concerned about her breasts should see her GP, regardless of her age. If she needs further tests, she will be referred to a breast clinic. This is outside the NHS Breast Screening Programme, which uses a routine call and recall system to invite well women without symptoms, but the same techniques are used in breast screening clinics and hospital breast clinics for diagnosing breast cancer and many staff work in both settings (see 'Diagnostic mammograms in the UK').

Many of the women we spoke with had heard of the NHS breast screening programme before they received their first invitation. Women who'd worked in the health field were particularly familiar with the programme and had access to a lot of information on both breast screening and breast cancer. Others told us that, although they were aware of the programme, they didn't know what to expect of the actual mammogram procedure. A few women, whose first language was Cantonese, hadn't heard about breast screening until they'd received the invitation letter. Their children translated it and the accompanying information leaflet for them. Information on breast screening is available in other languages from the NHS Breast Screening Programme.

The invitation letter
Women don't necessarily receive their first invitation for breast screening in the year that they turn 47, but will be invited sometime between their 50th and 53rd birthdays. A few women expected to receive an invitation at fifty and were concerned when it hadn't arrived. One person had been disappointed at having to wait until she was fifty-three for the mobile screening unit to revisit her area. Another paid for a private mammogram for her fiftieth birthday as she didn't want to wait up to three more years for her first NHS mammogram, partly because a colleague had recently been diagnosed with breast cancer.

Some women remembered when their invitation letter was due every three years after the age of 47. A few said that, on the odd occasion when it hadn't arrived in the month they'd been expecting it, they'd phoned the unit to find out why. Several women said they were grateful for being sent an invitation letter every three years and that, if they had to phone and make their own appointments every three years, there was a chance they'd forget. 

A few women wondered why they were routinely invited every three years and not more often. Others said that they'd visit their doctor if they did have any concerns between their three-yearly screening appointments. A large research trial in 2002 concluded that the NHS Breast Screening Programme has got the interval between screening and invitations about right at three years, compared with more frequent screening. The trial was organised through the United Kingdom Coordinating Committee on Cancer Research (UKCCCR) and was supported by the Medical Research Council, Cancer Research UK and the Department of Health. A few women chose to continue having mammograms after the age of 70 when they stopped being routinely invited (see 'Breast screening after age 73').

Several women had their first mammogram before the age of fifty. One woman had been going for screening since she was forty, because of a private health care scheme at work.

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Some women, who'd had benign problems at a younger age, said they'd had mammograms before the age of fifty (see 'Benign breast problems' and 'Diagnostic mammograms in the UK'). Other women, who'd had breast cancer in the family, had also been screened earlier. One woman had had her first mammogram at the age of 43 as part of a clinical trial of breast screening.

Most women were invited by post to attend for a routine mammogram. Although many felt that the accompanying leaflet gave them enough information about breast screening, some would have liked more (see 'Information'). A few women mentioned that they didn't read the information leaflet very carefully before their first mammogram. One person had read the leaflet after having her first mammogram in case the information was off-putting.

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A few women mentioned how easy it was to rearrange their appointment if they couldn't attend on the date they'd been given. One woman changed her appointment to a time in her menstrual cycle when her breasts would be less tender. Another felt that the invitation letter should also say when to expect the results letter. The information leaflet ('Helping you decide') that is sent with the invitation letter does now include informatrion about when to expect the results.

Last reviewed March 2016.

Last updated March 2016.

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