Health encyclopaedia - Alphabetical Topic List

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Diagnosis of Cancer of the breast

It’s very important to be aware of the normal look and feel of your breasts. You will probably find that your breasts feel different at certain times of the month due to changing hormone levels. For example, they may feel tender or lumpy just before your period. Once you know what is normal for you, you’ll be better able to notice any unusual changes.

Breast screening is available every three years free of charge through the NHS, to women aged 50 to 70. Breast screening is a way of finding abnormalities in the breast tissue at an early stage, when they are too small to see or feel. X-rays, called mammograms, are taken of each breast. Women over the age of 70 are not automatically invited for screening, but can still have free mammograms every three years by making their own appointment.

On average, most women start the menopause around the age of 50. Women under 50 aren’t offered routine screening because mammograms aren’t as effective in pre-menopausal women. The rate of breast cancer is also lower in women under 50 – the risk increases as you get older. If you’re under 50 and worried about a breast change or problem, it’s still very important to see your GP. Your GP may refer you to a hospital breast clinic, where you’ll have the same screening tests as are carried out on the screening programme.

Mamograms can identify cancer before a lump can be felt. X-rays of each breast are taken while the breast is carefully compressed (squashed) with a clear plate. Most women find this slightly uncomfortable, but it is only painful for a few.

A small number of breast cancers do not show up on X-ray, and sometimes abnormalities develop in between screening appointments. It’s therefore important to be breast aware - this means being familiar with the look and feel of your breasts, which will help you to recognise anything unusual. This is particularly important if you are over 50 and/or breast cancer runs in your family. See your GP if you notice any breast changes.

If your GP is at all concerned about a breast lump or other breast symptoms, they will refer you to a specialist. If you are referred urgently by your GP, a specialist should see you within two weeks. The specialist will ask some questions and then carry out tests to diagnose or rule out breast cancer.

A small number of women will be asked to go for further assessment when they receive their mammography results. Sometimes this is due to a technical problem with the mammogram, and sometimes this is because a suspicious area has been found on the X-ray. Being called for further assessment doesn’t mean you have cancer - many breast conditions (such as non-cancerous cysts) can show up on mammograms.

Further tests are carried out at a breast assessment clinic, usually in a hospital. They may include:

  • Examination by a doctor or nurse practitioner;
  • Further mammograms;
  • Ultrasound scan –a detailed scan that gives a picture of the internal breast tissue on a screen;
  • Fine needle aspiration (FNA) – using a small needle to draw off some fluid and cells from a lump or suspicious area in or around the breast;
  • Needle core biopsy – a small piece of tissue taken from the abnormal area. This is done using a local anaesthetic.

The amount of radiation used in mammograms is low - it is roughly the same as what you would be exposed to when flying to Australia and back from the UK. The amount of radiation is kept as low as possible, while still ensuring the mammograms are effective and reliable.

If you have any worries about going for a mammography, or what the results of your mammography mean, you should talk to you GP who will be happy to answer any questions you may have. See the selected links for further information.