radiation centre - breast cancer

Breast Cancer Screening – Everything Patients Need To Know

Many people are nervous about having a breast screening, mostly as they are worried what the results might show, and because they are not sure of what the process involves. 

Finding out about the procedure before stepping into the doctor’s office can make patients feel far more at ease, as they will not be faced with anything unexpected. 

Poor uptake in breast cancer screenings

When it comes to breast cancer screenings, although almost two million women attended their appointment in 2022-23 in England, 35.4 per cent who were invited did not. This is likely to be down to fear of the unknown and potentially hearing negative stories about the breast screening process. 

This increased to 46.3 per cent of women who received their first invite to a check, which comes after their 50th birthday. 

Of those who did attend, 18,942 women in England were found to have a cancerous lump in their breast, which might not have been discovered without the screening having taken place.

This shows just why attending a breast screening appointment, which is offered to women between the ages of 50 and 70 in England, is important, as it can detect something sinister that would have gone unnoticed and been able to spread. 

Health minister Maria Caulfield noted: “It is vital that women come forward for breast screening when invited, as early cancer diagnosis can make all the difference.”

She called for everyone to attend their appointment, adding: “It could be lifesaving.”

What are the barriers to breast screening?

Although the benefits of attending breast screenings are widely known, the figures show that many women are still reluctant to get themselves checked out. 

There are many reasons for avoiding screenings, including finding it difficult to book or reschedule their appointment. Some might not be able to take time off work for the screening, particularly if they are a full-time carer.

A lot of people struggle to travel to the breast screening venue, especially if they live in rural areas where public transport is limited. 

Additionally, some women might not receive an invite to a screening if they are not registered with a GP or have recently moved. 

There is also a stigma in some communities about revealing oneself and some women might not feel comfortable taking their clothes off in front of others. 

For many women, not knowing what to expect from their appointment can make them feel nervous and apprehensive about attending. 

They might not know what they should wear, for instance; whether they will be seen by a male or female member of staff; if the procedure is painful; and how long the whole thing could take. 

Their uncertainty about the event can deter them from coming, which could lower their chances of surviving if they are unfortunate enough to have a cancerous lump.

Deborah Tomalin, director of screening at NHS England, spoke about her experience of discovering breast cancer at her second check at 53. 

She stated: “I completely understand going for breast screening can feel daunting – some people might worry that it will be painful or be embarrassed to take your clothes off, but I can reassure you that the actual mammogram takes just a few minutes and any discomfort does not last long and the staff all look after you so well.”

Ms Tomalin added: “It really can save your life.”

What happens at a breast screening?

Knowing what to expect from a breast screening can alleviate anxiety about the procedure. For a start, it should only take around 30 minutes in total, during which four X-rays, or mammograms, are taken, two of each breast.

These will be carried out by female mammographers, who patients can talk to if they have any concerns before the X-ray.

Before the process, the patient will need to undress from the waist up and put a hospital gown on to preserve their modesty. They will also need to remove any necklaces and nipple piercings, and avoid using spray deodorant or talcum powder on the day of the appointment.

The mammographer will then place the breast on to the machine. For a few seconds, it will be squeezed between two plates while the X-rays are taken, which may be uncomfortable. The same thing is repeated for the other breast, so that images of both are taken. 

This is the end of the screening and the patient can then dress themselves again. They will then receive the results in the post a few weeks later. 

If any discomfort or pain is experienced during the mammogram, it is important to tell the mammographer who can stop it. 

It is also worth telling the staff of previous bad experiences with a screening, informing them of any nervousness or embarrassment, or any words they should not use as this will only increase anxiety. 

Receiving an abnormal result

Typically, four per cent of women are asked to return for more tests after their mammogram, as abnormalities have been found. This might not necessarily mean there is cancer, but another test, called a magnified mammogram, will be able to show clearer images of the problem areas. 

The hospital might even want to take cells from the abnormal area and run tests on them to determine whether they are cancerous or not. 

If it is discovered that the lump is breast cancer, patients need to consider their treatment options. Typically, this is done with surgery to remove the tumour, chemotherapy to attack the cancerous cells, or radiation therapy, which uses radiation rays to destroy the cancer cells. 

In terms of radiotherapy at a radiation centre, this can be delivered through external or internal radiation. The former targets the breast from outside of the body, while the latter involves placing a radiation device inside the breast tissue after surgery. This will deliver radiation on and off to the area for short bursts of time.

Treatment options will vary depending on the type of breast cancer, the size and the stage. 

Radiotherapy, for instance, could be used after surgery to reduce the risk of recurrence and kill any potential remaining cells, or it could be delivered to ease symptoms after the cancer has spread to improve quality of life; it could also be suggested in combination with chemotherapy to really attack the tumour. 

The patient’s oncologist will know the best course of action to take so their breast cancer is treated in the most effective way.