Mammograms and Clinical Breast Cancer Screening

In an effort to advocate Breast Cancer Awareness during the month of October, we will be promoting various topics regarding breast cancer detection, diagnosis and treatment. If you would like to learn more about breast self-exams and how to do one on yourself, follow this link.

However, self-exams are just one part of how we can reduce the impact of breast cancer on patients in the UK.

Mammograms are considered the gold standard in breast cancer detection. But what is a mammogram, how do they work, and who are they right for? This article covers the basics of mammography, what you can expect as a patient, and a few other points to set you on the right path regarding breast screening.

Mammograms & Clinical Screening

A mammogram is technically an X-ray of breast tissue taken through a specifically designed machine. This provides an image of the tissues that make up the breast.

Images taken of breast tissue during a mammogram can show suspicious lumps as small as a few millimetres wide. Tumours this small would be all but impossible to detect by yourself or by a doctor during a physical examination.

Clinical breast screening is not limited to mammograms, though they are the most specialised tool for breast screening. Ultrasound is also commonly used in combination with mammography to further investigate breast tissue. If any areas of concern are spotted, ultrasound can be used to identify if the lump is a typical fluid-filled cyst or a solid mass.

Cysts in the breast are somewhat common and generally not harmful. Solid masses are generally treated as potentially problematic and will likely be biopsied or surgically removed.

Do I need to have regular mammograms?

Generally, mammograms are not recommended for patients under the age of 50. Patients with a potential genetic predisposition for breast cancer will need to speak with their GP about their risk factors in order to decide if they are a good candidate for regular screening before this age.

Your GP may prescribe regular mammograms earlier in life if you have a family history of breast cancer or a direct family member who has had breast cancer.

What is the NHS Breast Cancer Screening Programme?

In the UK, any patient registered with their GP as a female who is over the age of 50 is automatically invited to have a mammogram under the NHS Breast Cancer Screening Programme. This programme sends mammogram invitations to these patients every three years until their 71st birthday.

This programme is optional, but regular mammograms are a great idea after 50 years old, given that a majority of breast cancer patients are diagnosed in their 50s or 60s.

Of course, mammograms are available to any patient if you notice an irregular change in the look or feel of your breasts or have a family history of breast cancer, as mentioned above. These may be available via your GP or private healthcare provider if you are younger than 50.

What is it like to have a mammogram?

The thought of having a mammogram for the first time can be quite daunting, but it’s really nothing to worry about. During a mammogram, the bare breast is placed between two plastic plates, and the practitioner will make sure you're comfortable and in the right position.

The top plate is then lowered onto the breast; you can expect to feel pressure, pinching and a squeezing sensation but only for a very short period of time. This process is repeated at different angles and on both breasts. Any metal piercings in the breast or nipple should be removed prior to having a mammogram.

Early screening and diagnosis increase recovery rates vastly; therefore, undergoing regular mammograms is highly recommended.

Breast Implants and Mammograms

Breast screening can be slightly more difficult in patients with breast implants; however, this should not be a deterrent against getting checked.

A mammogram will only take an image of the existing natural breast tissue, even for a patient with breast implants. Difficulties arise if the implant blocks part of the natural breast tissue in the X-ray image.

An experienced mammographer may take images from more angles than they normally would on a patient without implants to avoid missing any breast tissue in the images. It is very important you tell your mammographer that you have breast implants before the mammogram begins. You should also tell them if your implant or implants are ruptured.

Any questions or concerns you may have about breast cancer, mammograms or implants can be discussed with your GP, and they will be able to point you in the right direction.