Breast Screening Mammogram

Overview

A breast screening mammogram is an X-ray of the breast that looks for early signs of breast cancer in people who do not have any symptoms. It uses a very low dose of radiation to create clear pictures of the breast tissue. It can sometimes find cancer before a lump can be felt.

Breast cancer is one of the most common cancers in women worldwide. Routine mammogram screening is offered in many countries, including the UK through the NHS.

In the UK, breast screening is usually offered to people registered as female with a GP, aged 50 to 71. People at higher risk because of family history or genetic changes may be offered screening earlier or more often. Trans men and non-binary people registered as female may also be invited if they have breast tissue.

Symptoms

Common symptoms

• Screening is for people without symptoms, but between screenings, be aware of a new lump or thickening in the breast or armpit.
• A change in the size or shape of one breast.
• Nipple changes such as discharge, pulling in, a rash, or a sore that does not heal.
• Skin changes such as dimpling, puckering, or a red, warm area on the breast.

Causes

Main causes

• Breast cancer happens when cells in the breast begin to grow out of control.
• The exact reason this starts is not fully understood. It is usually a mix of genetics, hormones, and lifestyle factors.
• A mammogram does not cause breast cancer. The radiation dose is very low and the benefits of finding cancer early are much greater than the small risk.

Risk factors

• Getting older.
• Being female.
• A strong family history of breast or ovarian cancer.
• Previous breast cancer or certain non-cancerous breast conditions.
• Early first period, late menopause, or long-term use of combined hormone replacement therapy.
• Being overweight after the menopause.
• Drinking alcohol.

When to see a doctor

See a doctor urgently if:

• See your GP as soon as possible if you notice a new or unusual breast change, even if you have recently had a normal mammogram.

Book a routine appointment if:

• Attend your breast screening appointment when you receive an invitation.
• If you are aged 50 to 71 and have never had a mammogram, ask your GP or local breast screening service about booking one.
• If you have an increased risk of breast cancer, ask your GP about earlier or more frequent screening.

Diagnosis

A mammogram uses a low-dose X-ray machine. Each breast is placed on a flat plate, and another plate presses down gently to spread the tissue. The images are read by a specialist called a radiologist. If anything looks unusual, you may be invited back for further tests.

Tests that may be done

• Screening mammogram (the first X-ray of the breast).
• Diagnostic mammogram (a more detailed X-ray taken after a screening result).
• Breast ultrasound (sound waves to look more closely at a particular area).
• Biopsy (taking a small sample of tissue with a needle to test for cancer cells).
• MRI scan (sometimes used for people at higher risk or to get more detail).

What to expect at your appointment

At your appointment, you undress from the waist up in private. A female member of staff usually stays with you. The procedure can feel uncomfortable or slightly painful for a few seconds while the breast is pressed. Results are usually sent by letter within about two weeks. If you are called back, do not panic — most women who have further tests do not have cancer.

Treatment

If screening finds cancer, you will be cared for by a specialist breast team. Treatment depends on the type and stage of cancer, your general health, and your own choices. Your team will explain all your options and give you time to ask questions.

Self-care at home

• Continue to attend regular screening if you are invited.
• Tell your doctor about any breast changes between screening appointments.
• Bring someone you trust with you for support if you are anxious about your results.
• Ask for your results to be explained in a way that is easy for you to understand.

Medical treatments

Treatment may include surgery to remove the cancer, radiotherapy (high-energy rays to kill cancer cells), hormone therapy, chemotherapy, or targeted therapy. Many people have a combination of these. Your breast care team will create a plan tailored to you and will explain the benefits and possible side effects clearly.

When is surgery considered?

Surgery is a common treatment. It may remove only the lump and a small margin of surrounding tissue, or the whole breast in a procedure called a mastectomy. Reconstructive surgery to rebuild the shape of the breast may also be offered at the same time or later.

Living with this condition

Between screenings, it is helpful to be familiar with how your breasts normally look and feel. You do not need a special routine — just notice any changes and report them. Routine screening is part of looking after your health, not something to fear.

Lifestyle tips

• Keep up regular moderate physical activity.
• Maintain a healthy weight.
• Limit alcohol.
• Do not smoke.
• Try to eat a varied diet with plenty of fruit, vegetables and whole grains.

Diet and exercise

There is no special diet that guarantees breast health, but a balanced diet and regular activity help your overall wellbeing. After treatment, gentle movement can help with energy, sleep, and confidence. Your care team can advise what is right for you.

Mental health and emotional wellbeing

Waiting for screening results can be stressful, and being called back for more tests is a worrying time. It is completely normal to feel anxious. Remember that a call-back is often just a precaution. Talk to your GP or breast care team if worry is affecting your sleep or daily life.

Prevention

You cannot completely prevent breast cancer, but you can lower your chance by staying a healthy weight, being physically active, limiting alcohol, and avoiding unnecessary hormone therapy.

Vaccines

There is currently no vaccine for breast cancer.

Screening programmes

Regular breast screening does not prevent cancer, but it finds cancer early, when treatment is more likely to be simpler and more successful. In the UK, screening is offered automatically to people registered as female aged 50 to 71. If you have missed an appointment, it is never too late to ask for another one.

Complications

If left untreated

• If breast cancer is left undiagnosed and untreated, it can grow into nearby breast tissue and spread to lymph nodes.
• Cancer can later spread to other organs such as the bones, lungs, liver, or brain, which can become life-threatening.
• A late diagnosis may mean more extensive surgery or more aggressive treatment is needed.

Long-term outlook

The outlook for breast cancer found through screening is very good. Many breast cancers are treatable, and some are cured. Survival rates have improved greatly, and most people diagnosed with breast cancer live for many years. Your medical team will give you honest, individual guidance and support you throughout.

Find support

International organisations

• World Health Organization ↗

Local organisations

• NHS Breast Screening ↗ · United Kingdom
• Cancer Research UK ↗ · United Kingdom

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