Ductal Carcinoma in Situ (DCIS)

Routine mammograms: the UK Breast Screening Programme

One in eight women in the UK will develop breast cancer at some point in life (Breast Cancer Care February 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 NHS Breast Screening Programme (NHSBSP) was set up in 1988 with the aim of reducing the death toll from breast cancer. Women between the ages of 50-70 are invited for free breast screening every three years. Screening is for women without symptoms. Anyone with symptoms needs to speak to her GP. From 2010 the NHS Breast Screening Programme started phasing in an extension of the age range of women invited for breast screening to those aged 47 to 49 and 71- 73 in England. Women older than 73 are encouraged to make their own appointments for screening every three years. For more information see our 'Resources' section.

Women can ask their GP to refer them to a hospital breast clinic if they have a specific breast problem or are otherwise worried about the risk of breast cancer. This is outside the NHS Breast Screening Programme, which uses a routine call and recall system to invite well women, but the same techniques are used in breast screening units and hospital breast clinics for diagnosing breast cancer and many staff work in both settings (see Diagnostic mammograms).

The invitation

Most of the women we spoke with were diagnosed with DCIS that was found after a routine mammogram they’d had on the NHS Breast Screening Programme. Many of them had heard of the Programme before they received their first invitation, though didn’t know what to expect of the actual mammogram.

Because the NHS Breast Screening Programme is a rolling one that invites women from GP practices in turn, not every woman will receive an invitation as soon as she reaches screening age, but she will receive her first invitation within three years. She will then be invited every three years until her 70th birthday. The NHS call and recall system holds up-to-date lists of women compiled from GP records, and registers levels of attendance and non-attendance.

Most women said they had received a letter through the post inviting them for a routine mammogram, though one woman said a nurse had arranged her mammogram appointment for her when she went for routine cervical screening.

One woman, who was invited for her first mammogram at 49 (this was before the age of screening in some areas was lowered to 47), said she nearly didn’t go because she thought she may have been invited by mistake. Several other women who had been invited at 49 said they felt lucky to have been invited sooner rather than later, especially with hindsight because their DCIS might have become more serious had they had to wait another three years to be screened.

A few women expected to receive an invitation at fifty and were concerned when it hadn’t arrived. One person was disappointed at having to wait until she was fifty-three for the mobile screening unit to revisit her area.

A few women said that, when they received their first invitation for routine screening, they were reluctant to go because they were scared, expected it to be painful or considered they were not at risk of breast cancer. However, they were glad they had gone. One said her husband persuaded her to go. Several others said they had postponed their appointments because they’d been busy at the time, though had always intended to go. A few women noted how easy it was to rearrange their appointment if they couldn’t attend on the date they’d been given.

Some women said they were ‘scared’ before going for their first mammogram, though others said they had not been concerned. One said she had felt confident that nothing abnormal would be found but went because she was curious about the process. Another said she ‘dreaded’ going when she was invited every three years. Many women who had been for more than one mammogram, though, said they had always attended when invited and never really thought about screening before or afterwards.

A few women said they were glad the NHS Breast Screening Programme was set up because they probably wouldn’t have paid to have a routine mammogram privately. Others said that, if they weren’t routinely invited by letter, there was a chance they could forget to arrange their own appointment every three years, so were grateful the programme existed. A 72-year-old woman said she was surprised and pleased to be invited for screening when she was 70 because she had assumed she was no longer eligible.

Mammograms before the age of 50

A few women said they’d had mammograms before the age of fifty through private healthcare schemes. Some had known of or heard about other women who’d had breast cancer, so were particularly keen to find out if they were healthy. One woman said that, whenever she was invited for a routine mammogram on the NHS, she had the x-ray done privately because she had health insurance and would see the same doctor she’d seen before for breast pain.

Some women who have a family history of breast cancer have regular mammograms before the age of fifty. One such woman had had mammograms since she was forty-one and went into the Breast Screening Programme at fifty.

This woman had her first mammogram at the age of 43 as part of a clinical trial of breast screening.

Most women we interviewed said they’d had no symptoms before they went for routine screening. One woman, though, said that both she and her husband had noticed changes in her breast but she didn’t see her GP because she thought the changes could be related to the menopause. She waited until she was invited for a routine mammogram to find out if anything was wrong. Women often feel worried if they have breast symptoms, but it is best to see a doctor straight away. Most symptoms, including lumps, turn out to be harmless. In terms of breast cancer, the incidence increases with age. The older the woman, the higher her risk. 81% of cases occur in post-menopausal women: over the age of 50 (Breast Cancer Care February 2015).

Many women talked about their experiences at the screening unit and of the mammogram. See the Healthtalk Breast Screening site for more information.

A few women we spoke with had been diagnosed with DCIS outside the NHS Breast Screening Programme because they were under fifty and had symptoms. They were referred to a breast clinic by their GP (see Diagnostic mammograms).

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Last reviewed July 2017.

Last updated July 2017.


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