Breast Screening
Invasive breast cancer
The incidence of breast cancer increases with age: 8 out of 10 cases occur in women aged 50 or over (NHS Choices 2015). Most breast cancers are discovered by the woman herself. Women may have breast symptoms such as a lump, pain or changes in the nipple. Some cancers are found on the mammogram which is often taken as part of the NHS Breast Screening Programme. For some women we spoke with, their invasive breast cancer was discovered in this way. Mammography can detect small cancers that neither the woman herself nor a doctor can feel. Many women had had no symptoms and wouldn't have known anything was wrong if they hadn't been screened.
The NHS Breast Screening Programme invites women routinely every three years after the age of 50. Some women attending for their first mammogram were referred to a breast clinic for further tests and these showed breast cancer. One woman said that her first mammogram found 'suspicious tissue' that needed closer examination, which showed breast cancer. Another, whose breast cancer was found after her second routine mammogram, discussed getting the results and her treatment.
Had further tests after her first mammogram, which showed breast cancer.
Had further tests after her first mammogram, which showed breast cancer.
Working in screening anyway, you tend not to think too much about it. And then I got a letter to go to the assessment clinic. I didn't read it; I didn't read any of the leaflets. I had this attitude that it would be something wrong with the film and they'd just need to take more mammograms and so, I think I read the leaflets the day that I went for the assessment, realised that perhaps it wasn't quite just going back for a repeat mammogram so went for assessment.
And went back to the assessment clinic, got the results on the Thursday afternoon. They'd already made an appointment with the surgeon for the next day so although it was slow to start with, I actually got, you know, things moving quite quickly.
And I went to see the surgeon on the Friday, after being told that it was malignant. His view at the time was that it was a relatively small lesion, unlikely to have spread but that he was going to do a wide local excision.
'Suspicious tissue' found on her first mammogram turned out to be breast cancer.
'Suspicious tissue' found on her first mammogram turned out to be breast cancer.
And they brought me into another room and that's where the tears started because this other room had beautiful furnishings, lovely soft armchairs, a box of tissues in front of me and I thought, 'Oh God yes this is serious.' And they asked me had I anybody with me and I said 'No but my husband is coming to collect me'. So they - almost three hours had passed by this stage and they had booked me into hospital and they went outside to see if my husband was sitting outside. So he was outside waiting and as soon as he saw her coming towards him he panicked and he thought 'There's something wrong'. So he came in and we were told 'You're booked in for surgery'.
The surgeon explained what he would do.
The surgeon explained what he would do.
He would do, he called it a partial mastectomy and they would take some lymph nodes out at the same time.
One woman (before the lowering of the screening age) decided to have a mammogram done privately at the age of 47 because a colleague had recently been diagnosed with breast cancer. She was recalled for further tests, which showed breast cancer.
Decided to have a mammogram done privately because a colleague had recently had breast cancer.
Decided to have a mammogram done privately because a colleague had recently had breast cancer.
It was because [the Centre Manager] had actually been diagnosed with breast cancer. I think adding the whole thing - and I was coming up to fifty - and adding the whole thing together I just thought 'I think I'll treat myself to one for my birthday'.
Was recalled for further tests which showed cancer.
Was recalled for further tests which showed cancer.
So about a week later I actually went in and again I paid for this privately - I don't have private health care, it's just that I wanted to get it over with quickly. So I went in and had the stereotactic test, which was absolutely fine. I never felt a thing. So even though I was nervous going in, I had the ultrasound as well, I really was not in any sort of pain whatsoever, I never felt anything. They were extremely good, they gave me lots of local anaesthetic, not a thing.
The results came through the following week. And they came back as positive and I went in to see the Radiologist and he told me that it was grade five B, that it was an aggressive invasive cancer. But that it was only about sixteen millimetres in diameter and it was about four centimetres in my left breast. So I actually wouldn't have felt it at all, it was just there.
Women who aren't in the national screening age group and who have a close relative with breast cancer can ask their doctors whether they should have regular screening before the age of 47. One younger woman with such a family history had had annual mammograms since the age of 34. After her third mammogram, she was recalled for further tests and her biopsy showed a cancer. Another woman with a similar history had had mammograms before the age of 50 and took part in medical research on breast cancer. The research involved having a mammogram, which showed cancer. She was then advised about different treatment options.
Had screening because of a family history of breast cancer, and a cancer was found on her third screen.
Had screening because of a family history of breast cancer, and a cancer was found on her third screen.
So they did the mammogram and told me to wait, and just for the few minutes while we were waiting, still thinking they were going to come out with a smile on their face, and say no, no we think it's fine, it was just a shadow or something that wasn't clear on the x ray. Unfortunately they didn't. They came out and called us in and they could see something, and they wanted to get the consultant or the doctor that was there to have a look. He did a physical examination of the lump and then asked if they could do a biopsy there and then, which I had to....
Could you feel a lump?
No. No I couldn't feel the lump, and I felt really guilty that I couldn't feel the lump. I felt as though I should have been able to have found it. I checked, it was only - by the time they removed it, it was only two centimetres. When they did the biopsy she thought it was about one and a half centimetres, so it probably hadn't grown much by the time I'd had it out. They did a biopsy on that day, and then we had a very long three day wait, to go back to the hospital for the result. I think both of us knew [she and her husband] in the back of our minds that the chance it would be good news were quite remote, given the family history.
And then we went on the Friday back to see the consultant and to get the result of the biopsy. And they broke the news to us then that it was cancer.
A mammogram done in a research project detected a cancer.
A mammogram done in a research project detected a cancer.
Within a week I'd had a needle biopsy, which is a thoroughly unpleasant experience that I wouldn't recommend to anybody, but necessary, and the result of that was that it was a cancerous lump. A very small one, and not palpable by hand, so I really am extremely grateful to that mammogram, because it would have been another few months, possibly six months, before I was due for my next regular mammogram. These things can come so quickly in between.
What happened next? Oh then, of course, you get to the discussion as to what you are going to do, are you going to go for a lumpectomy, followed by, probably chemo or radio, or are you going to go for a complete mastectomy?
One younger woman had her first mammogram whilst on holiday in the United States. She'd had a gynaecological problem and the doctor treating her routinely screened women over the age of 35. She was surprised to be recalled for further tests and shocked when told she had breast cancer (see 'Breast screening and younger women').
Had her first mammogram in the USA because the doctor treating her routinely screened younger women.
Had her first mammogram in the USA because the doctor treating her routinely screened younger women.
Were you there on holiday, did you decide to stay longer?
No. The kids, when they were that age, had quite long holidays and I'd been here, I've been here now for sixteen years so I was here quite permanently. I was fully embedded in the English medical system having everything done here. I had just gone back to America for a holiday to visit my mother and my sister and I would never have had a mammogram here because I was nowhere near fifty. As far as I knew I wasn't at risk at all. I had had my medical exam in October. Nothing had been found. There was no palpable lump. You could not feel anything.
The only reason I had the mammogram was because this particular doctor had seen so many breast cancers with young women that he had his own rule about it, and I had this niggly little problem that I desperately wanted sorted out and I thought if it meant taking a mammogram to get a medication for it I was going to be very happy to do that. It's the only reason I had the mammogram because I just didn't think that somebody my age with no history of cancer in the family had any reason to do it.
Was surprised to be called back for further tests and shocked to hear that she had breast cancer.
Was surprised to be called back for further tests and shocked to hear that she had breast cancer.
I then went to a breast surgeon expecting him to look at the mammogram and laugh and say don't be absurd, you're fine. Go away. And in fact that didn't happen. He looked at it and said, you know, I think you need to have a biopsy, it will be a small surgery and that was a complete surprise. But I still, I don't think it still hit me that this was a true possibility.
We were supposed to go back three or four days later for the results of the biopsy and I fully expected it to be absolutely nothing. Instead he called my mother and told her that it was cancer and my poor mother was on her own completely when she found out and she had to come and meet me somewhere.
We had an appointment to meet up for lunch and during the course of lunch she just burst into tears and said 'You know the doctors called and it's cancer' which was to me completely, completely unthinkable. It just didn't seem a possibility.
One woman had an early form of breast cancer (Ductal carcinoma in situ - DCIS) which was found in a routine mammogram. After having the affected area of her breast removed, she had regular check-ups at the hospital. In one of these, a mammogram showed she had cancer in the other breast. Soon afterwards she developed a lump in her armpit and worried that the cancer might have spread. However, it turned out to be non-Hodgkin lymphoma (a type of cancer of the lymphatic system).
Had DCIS, then invasive breast cancer, and was worried that her cancer had spread.
Had DCIS, then invasive breast cancer, and was worried that her cancer had spread.
He [surgeon] started giving me an examination and he found a lump under my right arm so I thought, this is it. Now, I've got secondary breast cancer and it's come back into the right breast and I'm definitely going to die. And I'm going to have harsh treatment, chemotherapy, radiotherapy, I don't know how I'm going to deal with this. It was just the most awful time in my life.
And he came and sat beside the bed and he told me that it was a Non-Hodgkin's lymphoma and I thought, well, what does that mean? What does he mean? Fortunately, my husband was with me and he said, 'well, surely that's good news because that means that it's primary cancer. It's not a secondary, it's a different cancer?' And the surgeon agreed, yes that was the case. It hadn't been a secondary breast cancer; it was a Non-Hodgkin's lymphoma and, again, I would just have to have some, some small treatments and I would be fine.
The earlier that breast cancer is diagnosed and treated, the better the long-term prospects are for women with the disease. Many women have a choice about the treatment they receive depending on the type and location of their cancer. On our breast cancer section of this website, women with breast cancer talk about the different treatments they had, the impact the disease had on them and others around them, and what it is like to live with breast cancer.
Last reviewed March 2016.
Last updated March 2016.
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