Breast Screening
Diagnostic mammograms in the UK
Mammography is a technique for taking x-ray images (mammograms) of the breasts which can show breast cancers at an early stage. Mammography is used in the UK National Health Service Breast Screening Programme (NHSBSP) to look for breast changes in women who have no symptoms of breast cancer (screening mammograms). Mammograms are also used to diagnose breast disease in women who have symptoms. If a woman visits her doctor because of unusual breast changes, she will often be referred to a breast clinic to have a 'diagnostic mammogram'. The same techniques are used in breast screening units and hospital breast clinics for diagnosing breast cancer and many staff work in both settings.
Some women we spoke with went for diagnostic mammograms because they'd had breast symptoms.
One woman, who had been for a routine screening mammogram when first invited at age 50, had decided not to go again because she had found the mammograms very painful (see 'Reasons for not attending breast screening'). Some years later she noticed an indentation in her breast. She was referred to a breast clinic by her GP and found to have breast cancer.
She'd been screened once but decided not to go again. Some years later she noticed an indentation in her breast.
She'd been screened once but decided not to go again. Some years later she noticed an indentation in her breast.
Well as far as I can remember, I think it must go back twelve years, because I went for a mammogram at the National Health place, and I found it extremely painful. And I was bent double when I came out. So I said I'm not going to have another one, which should have been every three years, and I didn't go for it. And then of course I realised afterwards, well a few years I'd missed, obviously, and I found this indent in the breast, a breast indentation, whatever you call it.
I saw my GP. She referred me to the surgeon and it was a few weeks wait, and then I decided to go privately to a consultant, which I did, and he operated the next week.
At the breast clinic, women with breast changes or symptoms can have various diagnostic tests, including mammograms, MRI's, ultrasound scans, fine needle aspiration and other types of biopsy (see 'Referral to a breast clinic').
Although breast cancer is most common in women after the menopause, younger women (under 50) who are not screened in the NHS Breast Screening Programme, may develop breast symptoms and be referred for a diagnostic mammogram by their GP.
The DMIST study has shown that digital mammography is better for screening younger women (under 50) and women with denser breasts, and is equally effective as film mammography in older women. Whereas conventional mammography captures images of breast tissue on x-ray film, digital mammography uses computer imaging. All services in the NHSBSP are now fully digital with no anologue machines used in the Programme.
She discusses what happened when she had a sore and weeping nipple.
She discusses what happened when she had a sore and weeping nipple.
Well I'd gone with my daughter onto a sun-bed, which I have never done before, and it was just, I thought I would just go with her to see what it was like. And over the next few days my nipples seemed to be a bit sore, weeping. So, I went to my GP and she said to me "I think its eczema" and she gave me some cream.
I went back after a week and it hadn't done any, well there was no change in my nipple, it was still sore. So, she said "I think we'd better refer you to the hospital" and that took three months actually. I went back to her and I said, "I still haven't got an appointment" and my nipple was changing quite a lot by that time, it seemed to be getting a lot worse. Then I got my appointment through at the hospital. I went to the hospital.
Two young women described finding a lump while showering; they were referred to hospital for diagnostic mammograms and other tests. One woman presented what she thought was a lump to her GP who dismissed it as nothing, but found another lump which was suspicious and referred her to hospital.
She discusses finding a breast lump.
She discusses finding a breast lump.
I made an appointment, luckily I got an appointment very quickly with her, I explained to the receptionist what was going on. I went to the doctor explained that I had found a lump, she felt the lump and said "right, OK, we'll write a letter to the hospital", which she did.
She presented a lump to her GP who dismissed it as nothing but found another more suspicious one.
She presented a lump to her GP who dismissed it as nothing but found another more suspicious one.
I found what I thought was a lump. I was 39 and I thought what I'd do is just to wait a cycle or two to see if it disappeared and it didn't. So I went to see my GP and she gave me an exam and she said "no that's normal, there's nothing wrong, but I will give you a full exam" and she found a small lump under the nipple where, for some reason, I had never checked. I don't know why but I decided somewhere along the line that this really didn't need a special examination. I examined everywhere else but I kind of forgot to actually press underneath the nipple and she found something.
She said "it feels fine, don't worry, most of these lumps are benign, but I am going to send you on to the local surgeon".
Women's experiences of having a diagnostic mammogram at the breast clinic are similar to those of women attending for screening mammograms. However, women presenting with symptoms may be more anxious because they are expecting to find something wrong. Some women having mammograms as part of the NHS screening programme find the mammogram uncomfortable or painful. One woman presenting with symptoms, though, said she did not care about the discomfort of the mammogram because she was so distressed about what the results might be.
She didn't care about the discomfort of the mammogram because she was so worried about what her symptoms might mean.
She didn't care about the discomfort of the mammogram because she was so worried about what her symptoms might mean.
How did you find the mammogram? Did you know anything about...?
No, I'd just heard, I'd heard, because when, where I worked I had, was working with some mature ladies who had gone for mammograms and, you know, you hear stories, you hear, you know, all sorts of things. And it's not comfortable, that's the only way to put it. But at the time I think you're so worried and distressed that that is nothing. It is a small price to pay because you think, well what's a bit of discomfort if it's going to give you peace of mind?
Most women referred to hospital with breast symptoms have all their tests on the same day in so-called one-stop clinics. If a biopsy is needed, this is usually done on the same day. Some women we talked to received the results of their tests on the same day, while others had to wait a few days.
She had all diagnostic tests done on one day but had to wait a few days to get the results.
She had all diagnostic tests done on one day but had to wait a few days to get the results.
But that couldn't be done until the afternoon, so we had to go back in the afternoon to the hospital and they told us to go back on Thursday to have the results. When we went back on the Thursday, in the room was sitting the doctor, the Macmillan Nurse, and there were some medical students there as well and I just looked and I thought "no, something doesn't seem right, it just doesn't" you know "not right at all". I spoke to my husband the day before on the Wednesday and I kept on saying to him "what do you think, what do you think?" and he was like, he's had an open mind all the way, you know, he wouldn't believe it, he said "I'm keeping an open mind".
Last reviewed March 2016.
Last updated March 2016.
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