Breast Screening

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.

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.

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.

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.

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.