The National Health Service Breast Screening Programme (NHSBSP) was set up in 1988. Women between the ages of 50 and 70 are now routinely invited for free screening every three years. Screening is for all well women without symptoms, whether they have a family history of breast cancer or not. Women over 70 are encouraged to make their own appointments.

Breast cancer is the most common cancer to affect women, and breast screening using x-rays (mammography) is the only method that has been extensively studied and can detect breast cancer early. It 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.

Most of the women we spoke to supported breast screening and felt that it benefited women. Many attended for screening because they believed it was better to have any breast problems detected and treated early (see ‘Reasons for attending breast screening‘). Some women who turned out to have an early form of breast cancer (DCIS) were glad that screening had detected their problem before it had developed into anything more serious, but others were less convinced of the value of diagnosing a condition with such an uncertain prognosis (see ‘DCIS’ views on breast screening‘). Many women with invasive breast cancer felt that finding and treating their breast cancer before it caused any symptoms had helped them to recover well; some believed that screening had saved their life.

But no screening test is perfect. Sometimes the breast x-ray shows suspicious changes but further tests show that these are not cancer. Conversely, the x-ray may appear to be normal even though breast cancer is present. A few women who supported breast screening had mixed feelings before going for a mammogram if they’d previously been recalled for further tests. Some women, who’d been found to have breast cancer, also had mixed feelings before attending post-operation check-ups. Although they felt anxious about going for a mammogram because of what might be found, they felt reassured when told they had no further problems.

Some women felt that breast screening should be available to younger women, particularly those with a family history of breast cancer (see ‘Breast screening and younger women’). A few recommended that women pay to have mammograms before screening age and do whatever they could to look after their own health. Several people recommended that, after the age of 70, women should continue having breast screening because the incidence of breast cancer increased with age (see ‘Breast screening after age 70‘). Many women were grateful for the opportunity to be routinely screened. Some felt that routine screening should be available to women every two years instead of three years.

Although most women attend for routine breast screening because they believe it is responsible health behaviour, some choose not to go for various reasons (see ‘Reasons for not attending breast screening‘). A few women wondered about the benefits and risks of breast screening and whether it actually saved lives.