Reasons for attending breast screening

The National Health Service Breast Screening Programme (NHSBSP) was set up in 1988. Women between the ages of 47 and 73 are now routinely invited for free screening every three years. NHS Breast Screening is for all well women without symptoms, whether they have a family history of breast cancer or not. Women over 73 are encouraged to make their own appointments.

Most women accept their invitation for screening. Many whom we spoke with attended because they wanted any breast problem to be detected and treated early, before it became more serious. Most felt that breast screening benefited women because the sooner breast cancer was found and treated, the greater the chances of recovery. Knowing that breast cancer is common and that its incidence increases with age encouraged many women to be screened.

She says that screening benefits women because any breast cancer can be detected and treated early.

Age at interview 64

Gender Female

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So if someone was going to ask you what were your reasons for attending, because you go every three years, what would your personal reasons be?

Because it’s better to be safe than sorry. To make sure that there is nothing that, perhaps you cat feel a lump or anything and it’s further in, and to make sure that yore healthy because the longer you leave it the worse it is for anyone surely;

What would you say to women who don’t attend for screening?

I think that they’re very unwise, especially in this day and age where there is so much knowledge and obviously cancer treatment is getting better I believe. I’m fortunate not to have any cancer treatment, but, and it would be, it would be so quick to help them and get sorted out;

I mean women should know that it’s nothing to be afraid of, it’s something that is for their benefit actually.

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She says it was important to be screened knowing that the incidence of breast cancer increases…

Age at interview 52

Gender Female

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So you chose to go at the age of 49. What would your, if someone asked you what are your reasons for attending for breast screening, what would your reasons be?

Purely that I was aware that, you know when you reach the age of 50, the statistics of breast cancer go up and I just felt it was a safe, a safety thing really just to do that. That was my own personal feelings. And, as I say, simply because you know as you get older the statistics are higher;

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Some women went for breast screening because they wanted reassurance that they were well and didn’t have breast cancer. One felt that women should be made aware that, if they were not screened, breast cancer could be developing in their bodies without them knowing about it.

She goes for screening because she likes to know that she is well and healthy.

Age at interview 60

Gender Female

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I suppose because I’ve been offered a chance and the opportunity. And also you like to be told that you’re well, that’s another thing. People like to be told that theres nothing wrong with them, that they’re well. So we don’t, in this country, we don’t go for annual check-ups, like they do in the States, we don’t have that service and we usually go and see the doctor if were sick. But this is a procedure that you go relatively, well you think you’re well when you go in, think you’re OK when you go and you feel OK and it’s always nice to be told you’re OK. It’s nice to be told you’re well. And that’s a positive side of having the screening;

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One person said that women shouldn’t be put off by the embarrassment of having to undress to the waist. Others said that the pain or discomfort of mammograms shouldn’t deter women from attending because these are short-lived and the benefits far outweigh any discomfort. Some also felt the benefits of early detection were much more important than any small risks associated with x-rays.

She feels reassured by being screened and says embarrassment shouldn’t deter women from going.

Age at interview 60

Gender Female

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My personal reason is, well the big word is ‘reassurance really. Yes and as I say if you’re unfortunate enough to have a problem, the sooner you find out the better. And the sooner you can think positively and do something about it;

So you always attend regularly for breast screening;

Always yes;

Have you always attended for other kinds of screening like cervical screening;

Yes, yes;

So in general you’re quite positive about breast screening;

I am yes;

Is there anything you’d want to tell other people about breast screening?

No just that, don’t worry about it, you know, don’t worry about the embarrassment or anything just, just go for your own sanity, just go.

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She says that pain or discomfort shouldn’t deter women from going for screening as the benefits…

Age at interview 53

Gender Female

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Well, to prevent getting breast cancer and detecting it. Because I know that if it’s detected early theres a lot you can do but people that aren’t detected early on do suffer.

It’s not as if it does you any harm whatsoever, it does you good more than anything. And the very slightest two seconds of pain is nothing, really, it’s just like, it’s just a little bit more painful than cutting your finger, I suppose. It’s not very, not very bad at all. No, I would say, no you must go.

I’ve been impressed [with breast screening]. I’ve been impressed and I’ve been very satisfied and hopefully, I don’t actually get breast cancer but if I did, I know it would be detected at early stages and I’d be happy to have whatever treatment I need to have.

Because you’ve read quite a bit, do you think it takes the fear away?

Yes it does, yes. The more you know about something, the less scary it is.

Is there anything else you would want to tell people about breast screening?

I think I’ve pretty much said that I’m in favour of it and I believe every woman over the age of 40 should go for it, theres no reason why not.

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Some women said they liked to do whatever they could to look after their health. This included going for regular dental check-ups and cervical screening (smear tests) as well as mammograms. Breast screening was seen as one of several important aspects of health care. A 75-year-old woman, who had gone for screening since the NHS Breast Screening Programme was introduced, said she liked to take responsibility for her own health and breast screening helped her to feel she was doing all she could to look after herself (see ‘Breast screening after age 70‘).

She sees breast screening as an important aspect of health care, like going for smear tests and…

Age at interview 55

Gender Female

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Well I felt that if someone was offering me this opportunity to see if I was okay, I’ve always gone for smear tests and I’ve never had any hesitation to go for them. I am a positive person, I’ve always been a positive person and I felt if theres something there, I would rather know rather than not know. So I felt it was an opportunity to safeguard my life. If you need to go to the dentist, if you need glasses you go to the optician, you know so it was an opportunity for me to have something carried out that normally wouldn’t happen.

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Several women, who’d had benign breast conditions when younger, said that these experiences had made them more aware of breast problems and the importance of being screened. A few women felt that three yearly screens were too infrequent.

Having a benign cyst made her more aware of the importance of breast screening.

Age at interview 69

Gender Female

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And if I was to ask you what are your reasons for attending what would your reasons be;

Well because I had this cyst, probably if I hadn’t have had it I might, I don’t know, I might have gone really you know but that’s made me more aware to go;

Well I’d tell them [other people] that they ought to go really [for breast screening], I think everybody ought to go. If it’s only for, because I mean some people like you’ve heard about them and they’ve had these cancer things and all this, they don’t even know they’ve got them do they; I was just lucky really that mine, I don’t know whether that is the way the cysts go, like stick out like a little lump, you know what I mean, it wasn’t nothing, just like a little white lump you know.

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One woman had attended breast screening purely out of curiosity – she felt fit, healthy and didn’t believe she was at risk of developing breast cancer. She suggested that the NHS breast screening leaflet should say more about the risk factors associated with breast cancer and different kinds of breast cancers (see ‘DCIS‘). Another attended because she believed that every woman was potentially at risk of breast cancer. She felt that finding a lump would be much more worrying than going for screening, where any problems would be detected early.

She felt fit, healthy and not at any risk of breast cancer and went for screening out of curiosity.

Age at interview 52

Gender Female

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I went for my first mammogram, I was called for my first mammogram and I must say, looking back, I was incredibly naive about it. I went really out of curiosity because I’d reached the age where I knew you had screening, you had mammograms and we had talked about them and I ended up in it innocently because I really went to find out what it was like because I felt so certain that I didn’t have any form of breast cancer;

I didn’t feel myself to have any of the risk factors that I knew about at that stage. I’m quite small so I knew that overweight people were slightly more at risk, theres no family history. I had breast-fed my children and all these things I thought put me out of the risk category. And because I didn’t feel myself to have risk factors I thought I was safe from breast cancer and I realise now that was an absurd assumption. But I somehow thought that if you weren’t at risk you were safe. So I only went out of curiosity, I didn’t really go because I had considered I would be affected. And as a result I don’t think I read the screening literature particularly carefully. I just went along.

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She went for screening because she felt that every woman was potentially at risk of getting…

Age at interview 59

Gender Female

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So, if I was going to ask you, right at the beginning, what were your reasons for going for screening, what would you say?

Because I felt it was a possibility. It’s a possibility for every woman and I just, I think if I found a lump it would take me longer to go to the doctor, because of the fear. And it was much better going and getting it seen to early on. So I was delighted when I reached fifty to have that done.

Were you expecting the letter;

Yes. And in fact, I think it was just after my, it must have been about six or seven months after my fiftieth birthday so I sort of was a bit annoyed they didn’t see me straight away, but obviously they saw me in time.

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For some women, friends or colleagues being diagnosed with breast cancer underlined the importance for them of going for screening. One of these women said she chose to have a mammogram done privately before screening age rather than wait for her first NHS invitation as she felt that being screened was too important to wait up to three years. Another woman was from a family of health professionals and said she’d never questioned whether or not to go for breast screening.

For Susan, routine breast screening is ‘icing on top of the cake. She always attends her…

Age at interview 64

Gender Female

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You mentioned before we started the interview that you’ve always had clear results but that hasn’t always been the case with friends?

No, I’ve lost a lot of friends.

Through breast cancer?

Breast cancer. I have one at the moment whose been diagnosed within a month, a year younger than me, they found the shadow, it wasn’t a lump, it was like a shadow and she’s immediately had her breast removed and now she’s started to have chemo, so And I’d lost one this year, forty-nine year old who had it for twelve years. And then I lost one last year, who had it again for about twelve years, forty-eight. So it’s there in the back of your mind obviously, but I do check myself as well. But then it doesn’t always prove to be a lump, that is the problem. But the way of looking at breast screening for me as an individual is, that’s the icing on top of the cake, that’s a pun isn’t really because’ But they can find out, they can find out if it’s not there, that’s fine, and I’m very happy about that and I’m very happy about getting that letter.

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Rosemary always attends for routine mammograms. She had some done privately, before she was…

Age at interview 65

Gender Female

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Ive never had any problem. I suppose I think I must have had a couple of mammograms I cant think why, and then got into the, over whatever age it is that you start having them. Fifty or fifty-five or something like that?

Fifty.

And that’s all Ive had.

So before the routine screening at fifty you had a couple of mammograms?

I think I do recall that, maybe that was because I have a lot of friends whove had breast cancer.

Yeah, did you have those mammograms privately?

Probably yes, I think so yes.

Right so youve been, youve been very aware?

Aware?

Because of the experiences of friends?

There was a time when I knew eleven people who had breast cancer.

All within a certain age group or?

Mostly my sort of age group, one was a young woman who died. The rest, apart from one, have all survived and are fine. But one of them died, but they were all of similar age to me. So maybe it was fear again that sent me to do something, I cant remember. I don’t remember ever having any lumps or feelings like that, just concerns.

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Coming from a family of health professionals, shed never questioned going for breast screening.

Age at interview 52

Gender Female

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Well I’ve always gone for my cervical smear and I always thought it would be better to be safe than sorry. And I just thought no, I didn’t have any problems going because I just thought this is for me. In fact my father, who has passed away, was a doctor and my brother’s a doctor so were kind of felt, you know I’ll do the right thing medical-wise [laughs]. So I wanted to keep it up, I just wanted to do exactly the right thing. There was no question of not going.

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Some women went for breast screening before the age of 50 because they had a family history of breast cancer. A few took part in medical research on breast screening, which included having regular mammograms before they were 50. Many women we spoke to were grateful for the opportunity to be routinely screened every three years.

Miriam is grateful that women in the UK can get free routine mammograms, and feels that every…

Age at interview 61

Gender Female

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I’ve always attended, I’ve never turned round and said, ‘No I’m not going. Because like I said in the back of your mind you’re saying to yourself there’s nothing to say whatever you’ve got to do you can do it another time, you can do it another day, but, whatever you was gonna do today you can do tomorrow because in the back of your mind it’s always ‘if, why didn’t I attend?’ and you leave it too late and then they find out and then a letter comes and says, ‘If only I’d done what they told me to do. You see? But this is what I’m saying, what you is gonna do today if you had to go for a screen test or a smear test, you can always do, you can always cancel it and go another day.

A lot of women out there think that they haven’t got time, everybody’s got time in life, no matter who it is, you know you can find that little bit of time, just stop and think, ‘if I didn’t go, because if you don’t go and have it done, use it, you are lucky in this world to have letters sent to you, you’ve got everything here, take advantage of it. In the other parts of world have not got it at all, we are very lucky in this country to have all these facilities but there is people out there that do not take, take to it. You’ve got it take it while you can, and you can live, even a few years longer.

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