Who is screened for breast cancer?

The NHS Breast Screening Programme uses breast X-rays (mammograms) to screen all women aged 50 and over who are registered with a GP. Women aged 50 to 70 are sent an invitation to go for screening every 3 years. This is currently being extended to include women aged 47 to 73. Women over the invitation age range can still have screening every three years, by making their own appointment at their local breast screening unit.

We are sometimes asked why women of 51 or 52 haven’t had an invitation letter. This is because each local screening unit works through their area over 3 years on a rolling basis inviting women from each GP practice. So by the time 3 years has gone round, they will have covered the whole area and will then start at the beginning again. So everyone has at least one invitation before their 53rd birthday. The NHS breast screening programme is expanding the screening to cover women between the ages of 47 and 73 by 2012. Each unit will still follow a 3 year rolling programme, so not every woman will be screened when she is 47 but everyone will have at least one invitation before they are 50. If you feel that you may have missed an invitation for any reason it is best to contact your GP and ask them to tell your local screening service.

If you are younger than 50, your risk of breast cancer is very low. Mammograms are more difficult to read in younger women because their breast tissue is denser. So the patterns on the mammogram don't show up as well. There is little evidence that regular mammograms for most women under 47 reduce deaths from breast cancer.

About 3 out of 4 women (75%) go for their breast screening appointments when they are invited. In 2004 to 2005, more than 1.7 million women were screened for breast cancer in the UK. Only 5 out of every 100 (5%) were asked to go back for more tests.

Research is comparing having mammograms once a year to mammograms every 3 years. Some studies show a slight increase in the number of breast cancers picked up with annual screening, compared to 3 yearly screening. But we need more research to see whether this actually saves more women's lives and what effect the higher exposure to radiation from yearly mammograms has.

If you find a breast lump or any other breast change that worries you, always tell your doctor, even if you recently had a normal mammogram.

Women at higher than average risk of breast cancer due to a family history of breast cancer can have screening from a younger age. If you think you might be at increased risk, speak to your GP. They can refer you to a genetic specialist, who will be able to tell you. Not everyone with a family history of cancer is at increased risk themselves.

The National Institute for Health and Clinical Excellence (NICE) now recommends that women who have a moderate or high risk of breast cancer because of their family history should start having screening mammograms every year in their 40's. If you are younger than 40, NICE say you should only have mammograms as part of a clinical trial into screening. If you are under 30, you shouldn't be having mammogram screening at all. Mammograms are not reliable enough at picking up breast cancer in younger women. A joint NHS and Cancer Research UK study is looking into mammography for women in their 40's with a significant family history of breast cancer. The study has closed and we are waiting for the results. 

If you are younger than 40, your doctor may suggest screening using an MRI scan. NICE have recommended that women assessed to be at an increased risk of developing breast cancer, should be offered yearly MRI scans from the age of 30 or 40, depending on their level of risk.

If you have had tests that show you have a change in a gene (mutation) known to increase the risk of breast cancer, the recommendations are slightly different. NICE recommend yearly MRI scans from 

• Age 20 for women with a TP53 mutation
• Age 30 for women with a BRCA1 or BRCA2 mutation 

There is detailed information about the NICE MRI guidelines for breast cancer screening in our section about definite risk factors for breast cancer.

If you think you have a high risk of breast cancer because of your family history, you can talk to your GP. If they agree, they can refer you to a specialist breast clinic to have your risk assessed.

It is important to make sure that you know how your breasts normally look and feel, even if you are having mammograms every 3 years. Many breast cancers are still found by women themselves. Cancers can develop between mammograms. This is known as an interval cancer. If you notice any symptoms that could be due to breast cancer don’t wait until your next mammogram. See your GP straight away. There is information about how to check your breasts in the early detection section of CancerHelp UK.