Breast Screening

Overview

Breast screening is a health check that uses a low-dose X-ray, called a mammogram, to look for breast cancer before you have any signs or symptoms. Its goal is to find cancer early, when treatment is more likely to be successful.

Yes. In the UK, breast screening is offered through the NHS to women aged 50 to 70, and it is being extended to women aged 47 to 73.

It is offered to anyone registered as female with their GP, typically from age 50. Trans men, non-binary people, and people who have had breast surgery may also need screening, so it is best to ask your local breast screening service for advice.

Symptoms

Common symptoms

• A new lump or thickening in the breast or armpit
• A change in the size or shape of the breast
• Dimpling or puckering of the skin like the surface of an orange
• Discharge from the nipple or a nipple that turns inwards
• A persistent rash, redness, or scaling on the breast or nipple
• Constant pain in one part of the breast that does not go away

Symptoms in children

• Breast screening is not offered to children. Breast lumps in teenagers are usually harmless, but any persistent lump should be checked by a doctor.

Symptoms in older adults

• In older adults, the same symptoms apply. Screening continues for some women up to age 70 or 73. Anyone over 70 who is concerned about a breast symptom is still entitled to NHS screening every 3 years; simply ask your GP or local screening unit.

Causes

Main causes

• The exact cause of breast cancer is not fully understood. Breast cancer happens when cells in the breast divide and grow in an uncontrolled way.

Risk factors

• Being aged 50 or older
• Having a family history of breast or ovarian cancer
• Carrying certain inherited gene changes such as BRCA1 or BRCA2
• Starting periods early or menopause late
• Taking combined hormone replacement therapy (HRT) for a long time
• Drinking alcohol, smoking, or being overweight after menopause

When to see a doctor

See a doctor urgently if:

• A new, hard lump that feels different from the rest of the breast
• A lump that keeps growing or feels fixed in place
• Bloody or watery discharge from one nipple
• A dimpled or puckered area of skin on the breast

Book a routine appointment if:

• Any persistent breast change at any age
• If you have been invited for screening but missed it and would like to rebook
• If you are 71 or older and would like to continue screening; you can request it every 3 years

Diagnosis

Breast screening itself does not diagnose cancer. If your mammogram shows an area that needs a closer look, you will be invited back for more tests. These tests may include a new mammogram, an ultrasound, and a biopsy (taking a small piece of tissue).

Tests that may be done

• Mammogram (low-dose X-ray)
• Ultrasound scan
• Clinical breast examination by a doctor or nurse
• Biopsy — a small sample of tissue is removed with a needle and examined under a microscope

What to expect at your appointment

When you arrive for screening you will be given a private cubicle. A female mammographer will ask you to remove your top and bra. Your breast is placed on the machine and gently pressed flat while a picture is taken. This lasts a few seconds. It can be slightly uncomfortable from the pressure, but it is not usually painful. You will normally receive your results by post within two weeks.

Treatment

If screening does find cancer, a team of specialists will plan your care with you. Treatment depends on the type of breast cancer, its stage, and your general health. The usual treatments are surgery, radiotherapy, chemotherapy, and hormone therapy. Your team will explain the options and what each involves.

Self-care at home

• Follow your treatment plan and attend all appointments
• Talk to your breast care nurse about any side effects or worries
• Do gentle exercise as recommended by your team to keep your strength up
• Eat a balanced diet and stay hydrated
• Get emotional support from friends, family, or a counsellor

Medical treatments

Medical treatments for breast cancer are decided by your specialist team. You may be offered surgery to remove the cancer. Radiotherapy uses high-energy beams to destroy cancer cells. Chemotherapy uses medicines to kill cancer cells, and hormone therapy uses medicines that stop certain hormones feeding the cancer cells. Targeted therapy is another option that attacks specific features of cancer cells. You may have one treatment or a mix, depending on your situation.

When is surgery considered?

Surgery is often the first treatment for early breast cancer. It involves removing the whole breast (mastectomy) or just the part containing the cancer (lumpectomy). Some lymph nodes under the arm may also be removed to check if the cancer has spread. Your surgeon will explain what will be removed and why.

Living with this condition

Life after diagnosis and treatment can be physically and emotionally challenging. You will have regular follow-up appointments to monitor your recovery and check for any changes. Many people return to a full, active life, although it may take several months to regain energy. Be kind to yourself and set a pace that suits you.

Lifestyle tips

• Maintain a healthy weight through a balanced diet and regular activity
• Limit alcohol to recommended guidelines
• Stop smoking if you smoke — ask your GP for support
• Practice stress-reducing activities like walking, yoga, or mindfulness
• Attend all your follow-up appointments and consider annual reviews

Diet and exercise

Aim to eat plenty of fruits, vegetables, whole grains, and lean proteins. Regular exercise, including at least 150 minutes of moderate activity per week, can help reduce the risk of breast cancer coming back. Your healthcare team can help you plan a routine that fits your recovery stage.

Mental health and emotional wellbeing

A screening recall or breast cancer diagnosis can cause anxiety, fear, and mood changes. It is normal to feel overwhelmed. Speak to your breast care nurse, GP, or a counsellor. In the UK you can ask your GP for NHS talking therapies, or contact a charity like Breast Cancer Now for confidential support.

Prevention

Breast cancer cannot always be prevented, but certain lifestyle changes can lower your risk. Keeping a healthy weight, being physically active, limiting alcohol, and avoiding smoking all help. Breast screening does not prevent cancer, but it does increase the chance of catching it early.

Screening programmes

Regular breast screening every 3 years from age 50 is the most effective way to detect breast cancer early for most women. You will receive an invitation automatically on the NHS, but you can also contact your local screening service to book one if you have not been invited.

Complications

If left untreated

• If breast cancer is found late and left untreated, it can spread to other parts of the body, such as the lymph nodes, bones, liver, or lungs.
• Advanced breast cancer that has spread is harder to cure and can cause symptoms like severe tiredness, bone pain, and weight loss.
• A breast lump that is benign can sometimes press on surrounding tissue, causing discomfort or swelling, but it is not dangerous.

Long-term outlook

The outlook for breast cancer is excellent when found early. In England, more than 90% of women diagnosed with breast cancer survive for at least 5 years after diagnosis. Survival rates have improved greatly, and many women live long, active lives after treatment.

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