Every woman in the US is entitled to breast cancer screening. This starts from the age of 50, and continues up to your 74th birthday. You’ll be invited every two years, and they'll use your age and contact details from your doctor's records.
Breast cancer is the most common cancer in the US, and every 1 in 8 women is diagnosed in their lifetime. The risk grows with age, hence the screening starting at 50. It can occur in men, as they have breast tissue too, but it’s much rarer, so, they are not included in the screening program.
The aim is to pick up breast cancer early before you have symptoms. The best way to do this by imaging. A mammogram is a special X-ray that takes images of each breast, laid out and slightly compressed between two plates, with images taken at different angles. It’s not painful but you might find it slightly uncomfortable.
You may feel anxious about the procedure – it's understandable to be concerned that you will feel exposed. But you should rest assured that these are experienced professionals – image technicians, doctors and nurses – and they aim to put you at your ease and maintain your dignity and comfort at all times.
You will be seen in a special clinic, either at your local hospital, another local healthcare setting or in a mobile breast screening unit.
Your mammogram will be reviewed and if no abnormalities are found, they will inform you of this negative result by letter or email. Your doctor will also get the results. They will contact you directly if they have any need to perform further tests. About 1 in 25 women are called back for further tests – this doesn’t mean you have cancer, it may mean that the first mammogram wasn’t clear.
Other tests considered are an examination of the breasts and the lymph nodes leading up to the armpits or a fine needle aspiration or biopsy, where a sample of cells or tissue is extracted using a small needle. They may consider other methods of imaging such as an ultrasound, MRI or CT scan.
Of those called back for further assessment, 1 in 4 women will be diagnosed with breast cancer. To clarify, this is not 1 in 4 of all women attending for screening, it's out of the 1 in 25 recalled, so a much smaller chance.
The bottom line is, if you have any concerns about breast lumps or skin changes, you should see your doctor urgently. While more likely, as you get older, breast cancer can occur at any age. Women prior to menopause are more likely to get lumps and bumps related to their hormonal cycle – your doctor may suggest waiting to see if the lump goes away after your next period.
Younger women have more dense breast tissue, so they may be offered a 3D mammogram as this is a better way to view their breast tissue.
One of the definitions of a screening test is that you have no symptoms. If you are over 50 and develop any lump in your breast or armpit, this supercedes the screening program, so don't wait until you're invited for screening. Women of any age should book urgently with your doctor, who can refer you on a fast-track process to get this checked out.
Men can also develop breast cancer, although the risk is much lower, so any lumps in the breast tissue or armpits should be checked urgently by your doctor
If you reach the age of 74 and therefore at the end of the screening program, you will no longer receive automatic invites for a mammogram. Many women find the screening program reassuring, so this can be difficult to accept. However, even without symptoms, you can request your doctor refers you for a mammogram.
If you have a strong family history of breast cancer or ovarian cancer and wish to get checked out early, speak to your doctor about this. They will discuss your risks – be ready to answer lots of questions about the family members affected and what age they were diagnosed – and they may refer you to a specialist clinic.
You may have other risk factors for breast cancer, such as obesity, smoking and excess alcohol use, or taking hormone replacement therapy (HRT). It’s worth being aware of these and modifying the risks that you have control of, but it may not qualify to get you screened any earlier.
Risk factors aside, every woman is encouraged to examine her own breasts regularly to check for lumps – it's worth watching a video or looking at diagrams of this, as you need to have a systematic approach and know where breast tissue sits – it goes to the side of the upper outer chest and almost into the armpits. You should also check lymph nodes, which may appear as lumps right inside the armpits.
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