Screening if you have a moderately increased risk of breast cancer

Screening is tests to look for conditions or diseases when someone is not showing any symptoms of this.

All people registered as women with the NHS in the UK are invited to attend for breast screening by mammography every 3 years from the age of 50. This helps find breast cancer earlier, when they are smaller. Because of this, it is possible to cure more people with breast cancers detected by screening than it is to cure people who come forward with symptoms, for example, a breast lump.

Screening does not, however, prevent breast cancer; some people will still die of breast cancer despite having regular mammography. 

Breast cancer is more common as women get older and mammography is more sensitive at detecting cancer in older women. Screening success largely depends on how common the disease is and the ease with which it can be detected. Young women are more likely than older women to have cancers that cannot be seen on a mammogram. This is why breast awareness is important at any age. As there are disadvantages to screening as well as advantages, it is currently thought that the disadvantages outweigh the advantages in women under age 50. 

Mammography may detect a change in the breast that turns out to be 
non-cancerous. Tests may need to be performed before reassurance that all is well can be given. Each mammogram also gives you a small dose of radiation. Whilst we do not believe that this is a concern, it is theoretically possible that regular mammography in young women may actually cause a breast cancer to occur. 

The level of radiation exposure from a mammogram is equivalent to that experienced when flying to Australia and back. Another activity with roughly the same risk is driving a car for about 3,000 miles or living in an urban area for 3 months.  Attending a mammogram may also cause anxiety.

It is considered that, for young women at increased risk of breast cancer, the advantages of screening by mammography outweigh the disadvantages. Whilst there are still limitations with mammography, this remains the best way we have of detecting breast cancer earlier while it is small. 

One alternative to mammography is to be examined regularly by an expert in breast examination. There is little evidence to suggest that this is an effective method of screening. Other ways of imaging the breast are being researched but none have, so far, been shown to be better than mammography. 

We currently recommend mammography once a year for young women at increased risk of breast cancer. This is obviously more frequent than the 3 yearly mammography offered to women over age 50 as part of the UK National Screening Programme. This is because breast cancer in young women may appear more quickly than in older women. If you are aware of a breast problem before you are due to have your mammogram, please make an appointment with your General Practitioner for referral to our diagnostic service. If you are having regular clinic appointments, you can phone the helpline to arrange an earlier appointment.

Screening women who are at moderate risk of breast cancer usually starts at age 40. In women at very high risk it may start before this. 

For most women at increased risk of breast cancer, the risk gets less as they get older and their risk is then the same as the average risk for women with no risk factors. It is our normal practice to continue screening women at increased risk with mammography every year until age 50. However, some women at higher risk will be screened until 59. After this, you will have mammography screening every 3 years as part of the UK National Breast Screening Programme. You can consider continuing mammograms from the age of 50 to 59 if you are in the moderate risk group.  

If after reading this information, you would like to continue with annual mammography until the age of 59, you do not need to do anything. We will continue to contact you when your mammogram is due.

If after reading this leaflet you no longer wish to continue with annual mammograms until the age of 59 please contact the booking team on 01709 424807.
Email: rgh-tr.breastscreening@nhs.net

For more information, you can contact the Family History Breast Care Team on 01709 425627 Monday to Friday 9am to 5pm. If unanswered, there is an answer machine available. Please leave your details and the Breast Care Nurse will contact you as soon as possible.