Breast cancer screening - Frequently asked questions

I am a carer, looking after someone who lacks the mental capacity to make their own decisions about screening. They have been invited for screening. How should I deal with their invitation?

I'm in the process of changing from a man to a woman. I'm over 50. Am I entitled to breast screening?

I am changing from a woman to a man. Will I still be offered breast screening?

What happens to my mammograms after screening?

I haven't been called for breast screening even though I'm over 50 – do I need to contact anyone?

The NHS Breast Screening Programme is a rolling one, which calls women from doctors' practices in turn. This means not every woman receives her invitation as soon as she is 50. It will be sometime between the ages of 50 and 53.

In some parts of England, if you are aged 47-49, you could also be invited to screening as part of the trial extension of the breast screening programme.

If you are registered with a GP and the practice has your correct details, you will automatically receive an invitation. You don't need to contact anyone but you might like to ask your surgery when the women on their list are next due for screening.

Read more about when screening is offered.

I've found a lump in my breast – can you tell me how I can get a mammogram?

The NHS Breast Screening Programme is a population screening programme which invites all women aged 50 to 70 as a matter of routine. It is not aimed at women who already have symptoms.

If you have found something that worries you, don't wait to be offered screening – see your GP. He or she will decide whether or not you need to be referred for further investigations or treatment.

Read more about the symptoms of breast cancer.

My sister lives abroad and she gets more frequent breast screening. Why doesn't this happen in the UK?

A large research trial in 2002 concluded that the NHS Breast Screening Programme has got the interval between screening and invitations about right at three years, compared with more frequent screening. The trial was organised through the United Kingdom Coordinating Committee on Cancer Research (UKCCCR) and was supported by the Medical Research Council, Cancer Research UK and the Department of Health.

Here are the results from the UKCCCR Randomised Trial (PDF, 186kb) from the European Journal of Cancer, 2002.

I'm worried that breast screening will hurt because of the size of my breasts...

Don't worry. The mammography practitioners are used to screening women of all sizes and will do their best to minimise any discomfort.

During the mammogram each breast is placed in turn on the X-ray machine and gently but firmly compressed with a clear plate. The compression only lasts a few seconds and doesn't cause any harm. It's needed to keep the breast still and to get the clearest picture with the lowest amount of radiation possible.

Research has shown that for most women it's less painful than having a blood test and compares with having blood pressure measured. For women with very large breasts, additional pictures are sometimes needed to ensure that all the breast tissue is included.

Can I walk into the mobile breast screening unit and request a mammogram?

No – the NHS Breast Screening Programme doesn't operate on a walk-in basis. It invites women in the target age group (50 to 70) for routine breast screening every three years.

If you have found something that worries you or are concerned about your breast health, don't wait for your routine screening appointment. You should contact your GP.

Why does breast screening stop at 70?

It doesn't. Although women over 70 are not routinely invited for breast screening, they are encouraged to call their local breast screening unit to request breast screening every three years.

We produce cards to help them remember, which are handed out at their last routine breast screening appointment.

Can women with a physical disability be screened?

Mammography is a procedure that is technically difficult and that requires a high degree of cooperation between the mammography practitioner and the woman.

The woman has to be carefully positioned on the X-ray machine, and must be able to hold the position for several seconds. This may not be possible for women with limited mobility in their upper bodies or who are unable to support their upper bodies unaided.

If a woman has a physical disability or is a wheelchair user, the breast screening unit should advise on whether breast screening is technically possible, and where would be the most appropriate place for her to be screened. This will usually be at a static unit.

If a mammogram is not technically possible, the woman should still remain in the call and recall programme, as any increased mobility at a future date may make screening easier.

If a woman cannot be screened, she should be advised on breast awareness.

I am a carer, looking after someone who lacks the mental capacity to make their own decisions about screening. They have been invited for breast screening. How should I deal with their invitation?

If the person you care for is unable to make their own decisions about screening, then you, as their carer, should make what is called a 'best interests' decision on their behalf, in the same way as you may be making other decisions about their care and treatment.

You will need to weigh up the benefits of screening, the possible harm to them and what you think the person would have wanted to do themselves. Whether you are a paid carer, or an unpaid carer, family member or close friend, the process is the same.

Some people may have fluctuating mental capacity – in which case, the decision about screening should be delayed until the individual is able to decide for themselves.

If you do need to make a decision on someone else's behalf, consider what is involved in the screening process (including any further diagnostic tests that may be needed if the person receives an abnormal screening result). You may find it helpful to speak to their GP to discuss, for example, the person's risk of developing the cancer in question and how screening may affect them.

You must also consider what you think the person themselves would want. For example, did they used to go to screening, or express an opinion about it? Did they express more general views about their health and whether they would want to know if they had a disease or condition? Or did they refuse screening in the past?

Paid carers in particular should get advice from family members or friends about the person's views. If, after all this, you consider that screening is in the best interests of the person you care for, then you are within your rights to help that person to be screened. You should feel confident that if someone asks you, you will be able to explain the reasons for the best interests decision that you have made – either for, or against, screening.

To help someone with limited capacity to understand the screening process, you may find the picture leaflet An easy guide to breast screening helpful.

To find out more on making a best interests decision, the following publications are available from the Office of the Public Guardian:

Making decisions: A guide for family, friends and other unpaid carers (PDF, 390kb).

Making decisions: A guide for people who work in health and social care (PDF, 320kb).

To find out more about consenting to screening, please read our Consent to cancer screening guidance.

To find out more general information regarding consent and access to screening, please refer to our guidance Equal access to breast and cervical screening for disabled women.

I'm in the process of changing from a man to a woman. I'm over 50. Am I entitled to breast screening?

Individuals who are undergoing male to female gender reassignment may be screened as a self-referral at the request of their GP. If you have a symptom, you should see your GP in the usual way.

I am changing from a woman to a man. Will I still be offered breast screening?

Individuals who are undergoing female to male gender reassignment will continue to be invited for breast screening as long as they are registered as a woman, unless they ask to be removed from the programme or have had both breasts removed.

What happens to my mammograms after screening?

The NHS Breast Screening programme will keep your mammograms for at least eight years. These are saved securely.

The screening programme regularly checks records to make sure the service is as good as possible. Staff in other parts of the health service may need to see your records for this, but your records will only be shared with people who need to see them.

If you want to know the results of these regular checks, you can contact your local screening unit.