Breast screening and having a mammogram

Expert reviewer, Dr Adrian Raby, General Practitioner
Next review due June 2021

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, alongside other tests, if you have possible signs of breast cancer. This is sometimes called a diagnostic mammogram.

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National breast screening

The NHS runs a national breast screening programme for women in the UK. You can also have a breast screening mammogram at some private clinics.

In the UK, all women aged 50 to 70 are offered breast screening by the NHS every three years. In some parts of England, the NHS is trying out offering breast screening to women aged 47 to 73. Depending on how the trial goes, this may be extended to the rest of the country too.

You need to be registered with a GP to be invited for NHS breast screening. Your first invitation should arrive in the post before you turn 53. If you're 53 or over and haven’t received an invitation yet, contact your GP surgery. You may not be invited for breast screening once you’re over 70, but you can still have a mammogram once every three years. You’ll just need to arrange this yourself by calling your local breast screening unit. You may also be able to have private breast screening at a private clinic.

If you’re under 50 but have a higher-than-normal risk of developing breast cancer, you may also be offered a mammogram once a year. This may be because breast or ovarian cancer runs in your family (people with a gene called BRCA1 can have a higher risk of both). Speak to your GP if you’re worried about your risk of breast cancer – they may refer you to a genetic clinic for a risk assessment. Sometimes your GP will arrange this working together with your local breast clinic.

Deciding on breast screening

If you have 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 worth knowing about the potential benefits and risks. We’ve listed some points to consider below.

Talk to your doctor about any questions you have, to help you make a decision that's right for you. If you have any questions, you can also call or visit your local breast screening unit and speak to the staff there. You can search for your nearest breast screening unit on the NHS website.

Benefits of breast screening

Breast screening has several benefits.

  • Breast screening picks up over eight out of 10 breast cancers in women over 50.
  • Most cancers found during a mammogram are at an early stage – they may have been too small to see or feel.
  • Early breast cancer is usually easier to treat, and may need less treatment.
  • If breast screening doesn’t find anything wrong with your breasts, this can be reassuring.

Risks of breast screening

Breast screening does have some risks.

  • You may find having the mammogram uncomfortable (see our FAQ below on Is having a mammogram painful?).
  • There are some breast changes that might not develop into cancer. These can be picked up by breast screening, and you may end up having more treatment than you really would have needed.
  • You’ll be exposed to a small amount of radiation during the mammogram.
  • You may be called back for more tests, but then found not to have breast cancer. This can be stressful and upsetting.
  • No screening test is perfect and some cancers may be missed or not show up.

What happens during a mammogram?

Breast screening uses a low-dose X-ray called a mammogram to take images of your breasts. If you’re having your mammogram through the NHS breast screening programme, you’ll have it at a special breast screening unit. This may be at a hospital, clinic or in a mobile unit. Your mammogram will be carried out by a radiographer – a healthcare professional who specialises in taking X-rays.

Radiographers doing mammograms are always women. Before your mammogram, your radiographer will ask you about your symptoms and history of breast disease (including cancer). You don’t need to do anything in particular before your mammogram, and you can eat and drink as usual before your appointment.

When you arrive at your appointment, the radiographer will explain what happens during a mammogram and answer any questions if you have any. 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 find it easier to go to the mammogram wearing a skirt or trousers, rather than a dress. You may be given a hospital gown to wear.

The radiographer will show you where to stand for the mammogram, which will be very close to the X-ray machine. The mammogram takes two views of your breasts, one from above and one from the side. Your breasts are X-rayed one at a time. The radiographer will help you flatten your breast between two X-ray plates. The plates press your breast firmly to take the X-ray. Flattening your breasts in this way makes the picture clearer.

Your breasts are only pressed for a few seconds, but you may find this uncomfortable. Once the mammogram is over, you can get dressed and go home straightaway. You may feel a bit sore for a few hours afterwards. For more information, see our FAQ on Is having a mammogram painful?

Digital images of your breasts will be stored on a computer. They’re then looked at by a consultant radiologist.

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Getting the results of your mammogram

If you’ve had a breast screening (routine) mammogram

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 women who have a mammogram as part of the breast screening programme 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.

If you’ve had a diagnostic mammogram after possible signs of cancer

At around the same time as having a diagnostic mammogram, you may also have an ultrasound scan and possibly other tests. If there are any areas for concern, your doctor will ask you to have a breast lump biopsy. This means taking a sample of cells from your breast lump, to test whether it is cancerous or non-cancerous (benign).

You’ll usually be asked to come back for an appointment to receive your test results after a diagnostic mammogram. 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, or you may prefer to talk to others who have been through a similar experience via an online support group. Online forums at Cancer Research UK and Macmillan Cancer Support have discussions about waiting for results.

If your test results do show you have breast cancer, it can come as a huge shock. You’ll be allocated a specialist breast cancer nurse, who will be able to support you through your diagnosis and treatment. We have more information about breast cancer that you may find helpful.

Frequently asked questions

  • When you have a mammogram, the X-ray plates press your breast firmly for a few seconds. So, you may find breast screening uncomfortable. The radiographer will show you where to stand by the X-ray machine so that you’re as comfortable as possible.

    Some women do find a mammogram painful. If you’re one of them, always tell the radiographer before your appointment. They’ll try to reduce your chances of feeling any pain.

    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. If you’re not sure which painkiller to take, speak to a pharmacist or ask the radiographer when you have your appointment.

    You shouldn’t let any pain or discomfort put you off going to your next breast screening appointment. Having regular mammograms can detect breast cancer early on, before you notice any signs or symptoms. If you’re worried about pain after a mammogram, speak to your local breast screening unit.

    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 women aged between 50 and 70 for a mammogram every three years. In some parts of England, a trial is being done to invite women aged 47 to 73.

    If you’re under 50, you won’t usually be invited for breast screening, unless you’re at an increased risk of breast cancer. This could be if a close family member has had breast cancer, especially at an early age. Or if you have a family history of certain other cancers, including ovarian cancer, you may also be at increased risk.

    If you’re under 50, you may be offered screening using an MRI scan as well as a mammogram. An MRI scan uses magnets and radio waves to produce images of the inside of your body. This is because mammograms don’t work as well in younger women who haven’t gone through the menopause (when your periods stop). The average age of the menopause in the UK is 51.

    Before you reach the menopause, your breasts are made up of glandular milk-producing tissue. They don’t contain much fatty tissue, so your breasts tend to be dense (solid). If your breasts are dense, a mammogram is more likely to miss any changes that could be a sign of cancer. It’s also more difficult for doctors to read the mammograms correctly.

    It’s always important to contact your GP if you notice any changes in your breasts, no matter how old you are.

  • If you’ve had a breast implant after a mastectomy (removal of your natural breast tissue), you shouldn’t need to have a mammogram. But if you still have some of your natural breast tissue, as well as an implant, you’ll still need breast screening. If you have breast implants, mammography may not work so well. This is because X-rays can’t pass through an implant to the tissue behind it, so some of your breast tissue can be hidden from view.

    If you have breast implants, tell the radiographer when you arrive for your appointment. There are a number of things your radiographer can do to make the results more accurate. They may need to take more views of your breast tissue, to make sure they can see as much as possible.

  • Even if you’re having regular mammogram screening, it’s 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 for any change in size or shape, or in the way they feel. You should check your nipples too, looking for any discharge or changes in how they look. For more information, see Breast awareness.

    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.

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  • Reviewed by Graham Pembrey, Lead Health Editor, Bupa Health Content Team, June 2018
    Expert reviewer, Dr Adrian Raby, General Practitioner
    Next review due June 2021