Screening and Recall

Question 1

What percentage of women who undergo breast screening have a normal result?

Answer 1

96%

Question 2

Out of the 4% of women who have an ‘abnormal’ screening result, how many go on to be found to have cancer?

Answer 2

1% (1 out of 100 screened)

Question 3

How many women out of 5 who are found to have breast cancer through screening have a non-invasive breast cancer (DCIS)?

Answer 3

1 in 5

Question 4

How many women out of 5 who are found to have breast cancer through screening have an invasive breast cancer?

Answer 4

4 out of 5

Question 5

What is the purpose of breast screening?

Answer 5

To reduce the number of women who die from breast cancer

Question 6

What are the disadvantages and limitations of breast screening?

Answer 6

1. Mammography is uncomfortable and sometimes painful
2. Radiation exposure
3. False-positive results may cause unnecessary anxiety
4. Breast screening can sometimes miss a cancer
5. Breast cancer may develop between screening (in the 3 years between)
6. Screening may diagnose a cancer which never needed treatment

Question 7

When are women notified of their mammogram result?

Answer 7

Within 2 weeks of testing

Question 8

When does breast screening begin and how often is a woman called for screening?

Answer 8

From age 40-70 and they are called every 3 years.

Question 9

Can a woman have a mammogram after the age of 70?

Answer 9

Yes, as long as it is only every 3 years, and they have to self-arrange with the breast unit

Question 10

What advice might you give to a patient attending a breast screening for the first time?

Answer 10

1. You will need to be undressed from the waist up, so may be more appropriate to wear a top and skirt/trousers instead of dress
2. Avoid the use of talc and deodorant as this can interfere with the mammogram

Question 11

How many people interpret each mammogram?

Answer 11

2 people must independently assess the mammogram

Question 12

What is microcalcification?

Answer 12

Small specks of calcium salts that have formed in the breast tissue

Question 13

What is the concern surrounding microcalcifications?

Answer 13

They are common but can develop to form a ductal carcinoma in situ (DCIS)

Question 14

When calcifications are seen on mammogram, what should be done for the individual?

Answer 14

Stereotactic core biopsy

Question 15

Can DCIS spread?

Answer 15

In some cases, yes. It can invade into the wall of the milk duct and become a lump as an invasive carcinoma.

Question 16

How can we predict if a DCIS will spread and become invasive?

Answer 16

We can’t. We can however presume that ‘high grade’ DCIS has more chance to be able to become invasive.

Question 17

How can an area of micro-calcification be identified before surgery so that the surgeon can remove the correct area of the breast?

Answer 17

The morning of the surgery a fine wire is inserted into the area of calcification under mammographic guidance or a magnetic seed (MagSeed)

Question 18

How are women who had DCIS followed-up?

Answer 18

Annually have a mammogram for 5 years

Annually have a clinical examination for 5 years