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Research has shown that taking hormone replacement therapy (HRT) for five years or more may slightly increase the risk of developing breast cancer. It is also thought that this increased risk lessens after five years of stopping taking HRT. However, HRT can have health benefits such as reducing the effects of menopause such as osteoporosis. The benefits and possible risks to you of taking HRT need to be weighed up. You may want to talk to your GP about the benefits and risks to you personally of taking HRT.
If you are aged 50 or over, you should attend your regular breast screening appointments whether or not you are taking HRT. You do not need to have mammograms any more often if you are taking HRT. However, HRT makes the breast tissue slightly denser and can make breast problems more difficult to see on mammograms. So, it is important to be breast aware| if you are taking HRT.
You should tell your breast screening unit if you have had breast implants, as you will need to have your mammogram| at a screening unit where your mammogram can be looked at immediately. The mammogram technique used may need to be adapted to show as much breast tissue as possible on the x-ray. The pressure applied to your breasts during the screening is unlikely to damage your implants.
Mammograms for breast screening are not a check on your implants. If you think that there is a problem with your implants, please let the radiographer know.
If you have had all the breast tissue removed during a subcutaneous mastectomy and an implant put in, breast screening with mammography is not necessary for that breast.
Breast cancer is rare in women under 50|. At present, mammograms have not been shown to be as effective at detecting breast cancer in pre-menopausal women (women who have not had their menopause). The average age of the menopause in the UK is 50. After the menopause, the glandular tissue in the breast decreases and the breast tissue is increasingly made up of only fat. Fat shows up more clearly on the mammogram and makes interpretation of the x-ray more reliable.
Breast cancer is far more common in post-menopausal women and the risk of developing breast cancer increases as women get older.
The NHS Breast Screening Programme is gradually extending the lower age range for screening women in England to 47. This means that all women in England registered with a GP will receive their first screening appointment before their 50th birthday. New ways of doing mammograms using digital images are also being introduced because they are more reliable at detecting breast cancers in younger women.
For the time being, the other countries in the UK are continuing to screen women between the ages of 50 and 70. If you are under the screening age for the country you live in, and are concerned about a specific breast problem, you can ask your GP to refer you to a hospital breast clinic. This is not part of the NHS Breast Screening Programme; however, the same tests are used in both breast screening clinics and hospital breast clinics.
Large research studies have shown that increasing the frequency of screening mammograms doesn’t help to save lives from breast cancer. Having screening more regularly than every three years may increase anxiety for the women being screened. It will also involve more x-rays and greater exposure to radiation.
The breast screening unit will keep your mammogram for at least eight years. They can then compare your latest mammogram with those that you have had taken before.
The NHS Breast Screening Programme regularly reviews all screening records, including mammograms, as part of its aim to offer a quality service and to help increase the expertise of its specialist staff. This means that staff who work elsewhere in the health service will need to see your records. If a review of mammograms shows that you should have been cared for differently, you will be contacted and offered more information about the review of your case if you would like to have it.
The screening unit staff will do their best to reassure you and give you support during all stages of screening. Invitation and recall letters are carefully worded and give you the contact number of people to ring if you have any additional questions.
You will be sent a leaflet called NHS breast screening produced by the NHS Breast Screening Programme with your invitation letter. The leaflet is also on their website, where it is available in large print and is translated into 18 languages. Some translations are available in audio format. A British Sign Language version is also available. You will be given the number of the local breast screening unit and you can phone them or your own GP if you have any worries. You can also contact our cancer support specialists| or Breast Cancer Care’s helpline|.
Most breast cancers| occur in women. Fewer than one in a hundred (0.6%) breast cancers occur in men|. It is not clear exactly what causes breast cancer but many factors can slightly increase a woman's risk of developing breast cancer. These are mentioned below:
About 5-10% of breast cancers are thought to be caused by inherited cancer genes|. Two breast cancer genes have been identified (BRCA1 and BRCA2) and others may be found in the future.
Breast cancer is a common cancer and about one in nine women in the UK will develop it during their lifetime. So if you have just one or even two elderly relatives diagnosed with breast cancer it does not mean that you are at a much increased risk yourself. However, if you have any of the following in your close family you might want to speak to your GP and be referred to a family cancer clinic:
Your close relatives are your parents, children, brothers and sisters. They are sometimes called your first degree relatives.
If you are worried about breast cancer in your family our section about breast cancer and genetics| may be helpful. You could also use our online risk assessment tool| called OPERA to check you risk.
Content last reviewed: 1 January 2011
Next planned review: 2013
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
It is up to you whether you go for breast screening. It could help to find out the facts, which you can do by reading our cancer information team's blog in our online community. There, you can talk about your options with people who understand.
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© Macmillan Cancer Support 2013
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