Review of breast cancer screening

November 11, 2011

Following the recent, well publicised debate amongst clinicians and researchers regarding the pros and cons of breast cancer screening, an independent review of the NHS Breast Screening Programme has been announced.

The review, which will be led by Professor Sir Mike Richards (National Cancer Director) in partnership with Harpal Kumar, Chief Executive of Cancer Research UK, will examine all relevant evidence for breast cancer screening in an effort to quantify the complex balance of benefits and harms associated with the current screening programme.

There has always been debate about the pros and cons of screening.  The benefit of screening is in finding breast cancer at an early stage when there is a good chance of successful treatment and full recovery. The harm, however, is that screening also results in some women being ‘over-diagnosed’ – in other words, receiving a diagnosis of cancer that would not have led to death or sickness.  Different research studies and reviews have produced different figures for the relative number of women who benefit from screening versus those potentially harmed by it.

The report of the independent review is expected in early 2012.  Professor Julietta Patnick CBE, Director of the NHS Cancer Screening Programmes said: “We welcome this review announced by Professor Richards. The NHS Breast Screening Programme has always been based on the best and latest evidence. To ensure this, the Programme has been regularly reviewed over the more than 20 years that it has been running. We look forward to the findings of this latest review.”

Until the findings of the review are published and any decisions are taken regarding the future organisation and delivery of the national NHS Breast Cancer Screening Programme, breast screening services in London will continue to invite eligible women for breast screening as usual.

What are the signs and symptoms of breast cancer?

There can be many reasons for changes in the breast and often they will be harmless. Any unusual change needs to be checked as there is a chance it could be a sign of cancer:

  • size and shape: if one breast changes in size or shape
  • a new lump or thickening in one breast or armpit that is different to the rest of the breast
  • skin changes: puckering, dimpling, inflammation or redness of the skin
  • nipple changes: if a nipple becomes inverted (pulled in), changes shape or points differently
  • rashes on or around the nipple
  • discharge or fluid (not milky) from one or both nipples
  • pain or discomfort in the breast or armpit that is not related to your periods
  • swelling under the armpit or around the collarbone

Be breast aware

  • It is important to be aware of how your breasts normally look and feel at different times. You will then notice if something is different or if you develop any of the signs and symptoms listed above.
  • You can become familiar by looking and feeling your breasts from time to time in any way that is best for you.
  • You can feel your breasts in the bath or shower using a soapy hand or lying down in bed. Using body lotion can help. It is important to feel the whole breast including the armpit.
  • You can look at your breasts in the mirror. Move your arms (above your head, on your hips or by your sides) so that you can see your breasts from every angle, including the underside.
  • As older women are at greater risk of breast cancer, it is very important to be aware of any unusual changes after the menopause, when your periods have stopped.
  • Breasts may change with age and life events, such as pregnancy, breastfeeding, at different times of the month if you still have periods and after the menopause. This is why it is important to know what is normal for you so you will recognise any changes.

What to do if you find a change

If you notice any change in your breasts, tell your doctor without delay. Remember, you are not wasting anyone’s time.

Comments

***