Breast screening and having a mammogram

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Your health expert: Mr Giles Davies, Consultant Breast Surgeon
Content editor review by Pippa Coulter, October 2020
Next review due October 2023

A mammogram is an X-ray of your breasts that checks for signs of cancer. Breast screening mammograms aim to detect breast cancer early, before you or your doctor notices any signs of a problem.

Your doctor may also refer you for a mammogram and other tests if you have possible signs of breast cancer. This is sometimes called a diagnostic mammogram.

About breast screening

The NHS runs a national breast screening programme in the UK. If you’re aged 50 to 70 and registered with a GP, you’ll be offered breast screening by the NHS every three years. In some parts of England, people aged 47 to 73 may also be offered screening, as part of a trial into extending the age range. You can also have a breast screening mammogram at some private clinics.

You should receive your first invitation for screening before you turn 53. You won’t usually be invited for breast screening once you’re over 70. But you can still arrange your own mammograms by contacting your local breast screening unit directly.

If you’re under 50 but have a higher-than-normal risk of developing breast cancer, you may be offered a mammogram once a year. This might be if you’ve had genetic tests that show you’re carrying a gene associated with breast cancer, or if breast or ovarian cancer runs in your family. Speak to your GP if you’re worried about your risk of breast cancer – they may refer you to specialist genetic services or a breast clinic for further assessment.

Deciding on breast screening

If you’ve been offered breast screening as part of the national programme, it can be an important chance to check for any problems. But it’s your choice whether or not to attend, and it’s important to understand and weigh up the potential benefits and risks. We’ve listed some points to consider below.

If you have any questions about going for a mammogram, you can contact your local breast screening unit. You can also ask your GP for advice if you need help deciding whether or not to have breast screening.

Benefits of breast screening

Breast screening has several benefits.

It saves lives. It’s estimated that for every 200 people screened, one life is saved. This is because breast cancer is spotted and treated earlier than it would have been.
Early breast cancer is usually easier to treat and may need less aggressive treatment. For example, you may be able to have surgery that keeps your breast if your cancer is spotted early.
If breast screening doesn’t find anything wrong with your breasts, this can be reassuring.

Risks of breast screening

There are certain risks of breast screening that it’s important to be aware of.

Screening can pick up on breast cancers and pre-cancerous changes that would never have caused you any harm (overdiagnosis). You may then end up having more treatment than you really would have needed (overtreatment). This happens to about three in every 200 people.
The test isn’t perfect. You may have a ‘false positive’ result, where you’re called back for more tests, but then found not to have breast cancer. This can be stressful and upsetting, as well as having unnecessary investigations.
It’s also possible to have a ‘false negative’ result, which means your cancer is missed by the mammogram or doesn’t show up.
You may find having the mammogram uncomfortable. For more information on this, see our FAQ below: Is having a mammogram painful?
You’ll be exposed to a small amount of radiation during the mammogram which, over your lifetime, very slightly increases your risk of breast cancer.

Preparing for a mammogram

If you’re having a screening mammogram, you’ll have it at a special breast screening unit. This may be at a hospital, clinic, community centre or in a mobile unit. Diagnostic mammograms (when you’ve been referred by your doctor because you have breast cancer symptoms), are usually done at a specialist breast clinic with other tests. Your mammogram will be carried out by a female healthcare professional called a mammographer.

You don’t need to do anything in particular to prepare before your mammogram, and you can eat and drink as usual before your appointment. Bear in mind that you’ll need to undress to the waist for your mammogram, so you might want to wear something that’s easy to change out of. You’ll also be asked not to use talcum powder or a spray deodorant on the day because these can affect the mammogram.

If you’re pregnant, breastfeeding or have breast implants, let the breast screening unit know before your appointment. For more information, see our FAQ: Do breast implants affect screening?

What happens during a mammogram?

When you arrive at your appointment, your mammographer will check your details, explain what will happen and answer any questions you may have. They’ll ask you to confirm if you’re happy to go ahead. Then you’ll be asked to take off any clothes you’re wearing above your waist. This includes your bra if you wear one. You may be given a hospital gown to wear.

You’ll be asked to stand next to the mammogram machine, and your mammographer will help you to position one of your breasts onto the X-ray plate. They’ll then lower a second X-ray plate onto your breast, pressing it for a few moments. This helps to keep your breast still, and the images clear. The mammogram takes two X-rays of your breasts, one from above and one from the side. Your breasts are X-rayed one at a time.

Your breasts are only pressed for a few seconds, but you may find this uncomfortable. For more information, see our FAQ: Is having a mammogram painful? Once the mammogram is over, you can get dressed and go home straight away.

Specialist doctors called radiologists will look at the X-ray images of your breasts, to check for signs of cancer (normally two different doctors will check the images).

Getting the results of your mammogram

Breast screening mammograms

Your mammographer will tell you when you’re likely to get your results. It’s usually within two weeks. Most people will have a normal result. If your routine mammogram picks up anything abnormal, you’ll be asked to go to a breast assessment clinic for more tests. Around four in every 100 people who have a screening mammogram are called back for more tests. This doesn’t necessarily mean you have cancer – most women called back for more tests after a screening mammogram don’t have cancer.

Diagnostic mammograms

You may have a diagnostic mammogram done at a ‘one-stop clinic’, where you have other tests on the same day. These may include an ultrasound scan and a breast biopsy. A biopsy means taking a sample of cells from the area of concern to test whether it’s cancerous or non-cancerous (benign).

You may receive your results for a diagnostic mammogram on the same day. But you may have to wait a week or so to receive all your test results. It’s natural to be anxious while waiting for your results. You might find it helps to talk to those close to you about how you’re feeling. Cancer Research UK and Macmillan Cancer Support have online forums where you can also talk to others who have been through a similar experience.

Breast awareness

Even if you’re having regular mammogram screening, it’s still important to be ‘breast aware’. This means knowing what your breasts look and feel like normally, so you’re more likely to notice any changes.

Check your breasts regularly. Look for any change in size or shape, any skin changes such as puckering or dimpling, and any changes in the way your breasts feel. Check the whole of your breast area, including your upper chest, up to the collarbone, and your armpits. You should check your nipples too, looking for any discharge, redness, rash or changes in how they look.

Most changes in your breasts or nipples won’t be signs of cancer. But contact your GP as soon as you can if you notice anything unusual for you, even if a recent mammogram didn’t find anything.

Worried about breast health?

Book a breast check, which includes a mammogram† and get a picture of your current health with our breast health check.

To book or to make an enquiry, call us on 0370 218 8122^∧

However, if you are concerned that you may have a lump, please book an urgent GP appointment for assessment, it may be more appropriate to refer you to a specialist.

Find out more about our GP services

Having a mammogram can feel a bit uncomfortable, rather than painful, because the X-ray plates need to press quite firmly against your breast. Some people do find it more painful, but this should pass quickly.

Your mammographer will try to make you as comfortable as possible, but if you feel like you can’t continue, it’s your choice to stop the procedure at any time if you wish.

You may feel a bit sore around your breasts for a few hours after a mammogram, so take it easy for a while. You can take over-the-counter painkillers such as ibuprofen or paracetamol to ease any pain.

Don’t let any pain or discomfort put you off going to your next breast screening appointment. Having regular mammograms can detect breast cancer before you notice any signs or symptoms. If you’re worried about the mammogram being painful, tell the mammographer when you go for your appointment. They’ll be able to reassure you and try to reduce your chances of feeling any pain.

Different women say different things about their experiences of having a mammogram. Here are some examples of how women described having a mammogram to Bupa as part of a small survey in 2018.

“Uncomfortable (bordering painful) but only lasted a short time.”
“Awkward but painless.”
“Absolutely fine. A friend had described it as painful, did not find it to be at all.”
“Not as painful as I expected. Just a little uncomfortable and unusual.”

The NHS breast screening programme invites you for a mammogram every three years between the ages of 50 and 70. In some parts of England, a trial is being done to invite people aged 47 to 73.

You tend to have more solid breast tissue when you’re younger. So, any changes to your breast tissue are unlikely to show up as well on a mammogram, and it’s more difficult for doctors to read your mammogram correctly.

You may be invited for screening before the age of 50 if you’re at an increased risk of breast cancer. This could be if you carry a gene associated with breast cancer or if members of your family have had breast or ovarian cancer. In this case, you may be offered screening using an MRI scan as well as a mammogram. MRI gives a clearer image of your breasts if you’re a younger woman.

It’s always important to contact your GP if you notice any changes in your breasts, no matter how old you are. They can refer you for further investigations and tests, including a mammogram, if they think necessary.

Yes, having a breast implant can make mammography more difficult. It can make it harder to see some of your breast tissue in the images taken during the mammogram. There’s no evidence that an implant has ever ruptured (burst) due to being compressed during a mammogram. However, your mammographer will still take extra care to prevent this happening.

It’s still just as important to have a mammogram if you have an implant, and still have some of your natural breast tissue. If you’ve had a breast implant after a mastectomy (removal of your natural breast tissue), you won’t need to have a mammogram on that side.

Contact the screening unit to let them know before your appointment if you have an implant. Your mammographer may use a special technique and take more images of your breast tissue, to make sure they can see as much as possible.

If it’s easy to take your piercing out before your mammogram, it’s probably a good idea to do so. Having a nipple piercing can make it difficult for your doctor to see the images from the mammogram clearly. It might also make it a bit painful when you have your mammogram. If it’s only a small piercing though, it might not cause any problems and it wouldn’t usually stop the mammogram going ahead. Your mammographer will be able to tell you on the day if there’s likely to be a problem.

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