Common questions about breast screening

Transcription

1 Common questions about breast screening This information is an extract from the booklet, Understanding breast screening. You may find the full booklet helpful. We can send you a copy free see page 6. Contents Hormone replacement therapy (HRT) and mammograms Will breast implants affect my mammogram? Why are younger women not screened? Why are women only screened every three years? What happens to my mammogram x-rays? What if I am worried about screening? What are the causes and risks of breast cancer? Hormone replacement therapy (HRT) and mammograms Research has shown that taking HRT for five years or more may slightly increase the risk of developing breast cancer. It s also thought that this increased risk lessens five years after you stop taking HRT. However, HRT can have health benefits including reducing the effects of menopause such as osteoporosis. The benefits and possible risks to you of taking HRT need to be weighed up. You may want to talk to your GP about the benefits and risks to you personally of taking HRT. Macmillan and Cancerbackup have merged. Together we provide free, high quality information for all. Questions about cancer? Ask Macmillan Page 1 of 6

2 If you are aged 50 or over, you should attend your regular breast screening appointments whether or not you re taking HRT. You don t need to have mammograms (breast x-rays) any more often if you are taking HRT. However, HRT makes the breast tissue slightly denser and can make breast problems more difficult to see on mammograms. So, it s important to be breast aware if you are taking HRT. Will breast implants affect my mammogram? You should tell your breast screening unit if you have had breast implants, as you ll need to have your mammogram at a screening unit where your mammogram can be looked at immediately. The mammogram technique used may need to be adapted to show as much breast tissue as possible on the x-ray. The pressure applied to your breasts during the screening is unlikely to damage your implants. Mammograms for breast screening aren t a check on your implants. If you think that there s a problem with your implants, let the radiographer know. If you have had all the breast tissue removed during a subcutaneous mastectomy and an implant put in, breast screening with mammography is not necessary for that breast. Why are younger women not screened? Breast cancer is rare in women under 50. At present, mammograms have not been shown to be as effective at detecting breast cancer in pre-menopausal women (women who have not had their menopause). The average age of the menopause in the UK is around 50. After the menopause, the glandular tissue in the breast decreases and the breast tissue is increasingly made up of only fat. Fat shows up more clearly on the mammogram and makes interpretation of the x-ray more reliable. Breast cancer is far more common in post-menopausal women and the risk of developing breast cancer increases as women get older. Page 2 of 6 Questions about cancer? Ask Macmillan

3 The NHS Breast Screening Programme is gradually extending the lower age range for screening women in England to 47. This means that all women in England registered with a GP will receive their first screening appointment before their 50th birthday. New ways of doing mammograms using digital images are also being introduced because they are more reliable at detecting breast cancers in younger women. For the time being, the other countries in the UK are continuing to screen women between the ages of 50 and 70. If you are under the screening age for the country you live in, and are concerned about a specific breast problem, you can ask your GP to refer you to a hospital breast clinic. This is not part of the NHS Breast Screening Programme; however, the same tests are used in both breast screening clinics and hospital breast clinics. Why are women only screened every three years? Would it be better to have mammograms more often? Large research studies have shown that increasing the frequency of screening mammograms doesn t help to save lives from breast cancer. Having screening more regularly than every three years may increase anxiety for the women being screened. It will also involve more x-rays and greater exposure to radiation. What happens to my mammogram x-rays? The breast screening unit will keep your mammogram for at least eight years. They can then compare your latest mammogram with those that you have had taken before. The NHS Breast Screening Programme regularly reviews all screening records, including mammograms, as part of its aim to offer a quality service and to help increase the expertise of its specialist staff. This means that staff who work elsewhere in the health service will need to see your records. If a review of mammograms shows that you should have been cared for differently, you will be contacted and offered more information about the review of your case if you would like to have it. Questions about cancer? Ask Macmillan Page 3 of 6

4 What if I am worried about screening? The screening unit staff will do their best to reassure you and give you support during all stages of your screening. Invitation and recall letters are carefully worded and give you the contact number of people to ring if you have any additional questions. You will be sent a leaflet called NHS breast screening produced by the NHS Breast Screening Programme with your invitation letter. The leaflet is also on their website (www. cancerscreening.nhs.uk/breastscreen/), where it is available in large print and is translated into 18 languages. Some translations are available in audio format. A British Sign Language version is also available. You will be given the number of the local breast screening unit and you can phone them or your own GP if you have any worries. You can also contact our helpline on What are the causes and risks of breast cancer? Most breast cancers occur in women. Fewer than 1 in 100 (0.6%) breast cancers occur in men. It is not clear exactly what causes breast cancer but many factors can slightly increase a woman s risk of developing breast cancer. These include: The risk of breast cancer increases with age. More than 80% of breast cancers occur in women over 50. Having had breast cancer before. Having had certain types of benign breast disease (lobular carcinoma in situ or atypical lobular hyperplasia) in the past. Women who have never breastfed are slightly more likely to develop breast cancer than women who have breastfed for more than a year. Women who are taking hormone replacement therapy (HRT) or have recently been taking it have a slightly increased risk of breast cancer. Women who haven t had children are slightly more likely to develop breast cancer than women who have. Page 4 of 6 Questions about cancer? Ask Macmillan

5 Women whose periods start early (early puberty) or who have a late menopause have a slightly higher risk of breast cancer. Being overweight, once you have had your menopause, can increase the risk of breast cancer. Drinking more than two units of alcohol a day over many years can increase the risk. A unit of alcohol is half a pint of normal strength lager or beer, a small glass (125ml) of wine, or a single measure (25ml) of spirit. Having a family history of breast cancer About 5 10% of breast cancers are thought to be caused by inherited cancer genes. Two breast cancer genes have been identified (BRCA1 and BRCA2) and others may be found in the future. Breast cancer is a common cancer and about 1 in 9 women in the UK will develop it during their lifetime. So if you have just one or even two elderly relatives diagnosed with breast cancer, it doesn t mean that you are at a much increased risk yourself. However, if you have any of the following in your close family you might want to speak to your GP and be referred to a family cancer clinic: three close blood relatives from the same side of the family (your mother s or your father s) who developed breast cancer at any age, or two close relatives (from the same side of the family) who developed breast cancer under the age of 50, or one close relative who developed breast cancer under the age of 40, or breast and ovarian cancer on the same side of the family, or a male relative with breast cancer, or a close relative with cancer in both breasts. Your close relatives are your parents, children, brothers and sisters. They are sometimes called your first degree relatives. If you are worried about breast cancer in your family our leaflet, Are you worried about breast cancer?, may be helpful. You could also use our online risk assessment tool called OPERA to check your risk macmillan.org.uk/opera. Questions about cancer? Ask Macmillan Page 5 of 6

6 More information and support If you have any questions about cancer, ask Macmillan. If you need support, ask Macmillan. Or if you just want someone to talk to, ask Macmillan. Our cancer support specialists are here for everyone living with cancer, whatever you need. Call free on , Monday Friday, 9am 8pm We make every effort to ensure that the information we provide is accurate but it should not be relied upon to reflect the current state of medical research, which is constantly changing. If you are concerned about your health, you should consult your doctor. Macmillan cannot accept liability for any loss or damage resulting from any inaccuracy in this information or third party information such as information on websites to which we link. Macmillan Cancer Support Registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). Registered office 89 Albert Embankment, London, SE1 7UQ REVISED IN JANUARY 2011 Page 6 of 6 Questions about cancer? Ask Macmillan