Common questions about breast screening

You may have lots of questions about having breast screening. You can speak to your doctor about any worries and questions that you have. Most women would like to know more about these things:

  • Hormone replacement therapy (HRT) – Taking HRT for five years or more may slightly increase your risk of developing breast cancer. But you don’t need to have mammograms more often if you are taking HRT.
  • Breast implants – Tell your radiographer if you have breast implants. The mammogram technique may need to be adapted to show as much breast tissue as possible on the x-ray. The mammogram is unlikely to damage your implants.
  • Age – The risk of breast cancer increases with age. Nearly half of all breast cancers (45%) are in women over 65.
  • Worry and anxiety – The staff will try to reassure and support you through your screening. If you’re worried, you can talk through your thoughts with our cancer support specialists.
  • Causes and risks factors – There are lots of different factors that can increase your chance of developing breast cancer.

Will hormone replacement therapy (HRT) increase my risk of cancer?

Research has  shown that taking HRT for five years or more may slightly increase the risk of developing breast cancer. It’s also thought that this increased risk lessens five years after you stop taking HRT. However, HRT can have health benefits including 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 this.

If you are aged 50 or over, you should attend your regular breast screening appointments whether or not you’re taking HRT. You don’t 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’s important to be breast aware if you are taking HRT.

Will breast implants affect my mammogram?

You should tell your breast screening unit if you have breast implants, as you’ll need to have your mammogram at a screening unit where your mammogram can be looked at immediately. The staff will want to check that the images show as much of your breast tissue as possible.

The pressure applied to your breasts during the screening is unlikely to damage your implants.

Mammograms for breast screening aren’t a check on your implants. If you think that there’s a problem with your implants, let the radiographer know.

If you have had all the breast tissue removed during a mastectomy and an implant put in, breast screening with mammography is not necessary for that breast.

Why are younger women not screened?

Women younger than the screening age aren’t routinely offered breast screening. This is because breast cancer is uncommon in women under 50 and mammograms are less effective in women before menopause (around the age of 50). After menopause a woman’s breast tissue is less dense which means there is less glandular and connective tissue and more fatty tissue. This makes mammograms easier to read and the results more reliable.

Women under 50 who have an increased risk of breast cancer because of family history may be offered regular screening. Mammograms using digital images can be used. These are better at detecting breast cancers in younger women.

We have more information about breast screening in women under 50 with a family history of breast cancer.

What if I am worried about screening?

The screening unit staff  will do their best to reassure you and give you support during all stages of your 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 helpline or Breast Cancer Care’s helpline.

What are the causes and risks of breast cancer?

Most breast cancers occur in women. Fewer than 1 in 100 (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 include:

  • The risk of breast cancer increases with age. Nearly 45% of breast cancers occur in women over 65.
  • Having had breast cancer before.
  • Having had certain types of benign (non cancerous) breast disease in the past.
  • Women who have never breastfed are slightly more at risk than women who have breastfed for more than a year.
  • Women who are taking hormone replacement therapy (HRT) or have recently been taking it have a slightly increased risk of breast cancer.
  • Women who haven’t had children are slightly more likely to develop breast cancer than women who have.
  • Women whose periods start early (early puberty) or who have a late menopause have a slightly higher risk of breast cancer.
  • Lifestyle factors can increase the risk. Being overweight after menopause and drinking more than two units of alcohol a day over many years can increase the risk. Smoking heavily from a young age can also increase risk.

Having a family history of breast cancer

Most women diagnosed with breast cancer don’t have any family history of it. Only a very small number of women with breast cancer (5-10%) have a gene that greatly increases the risk of breast cancer. The two genes most often found in hereditary breast cancer are called BRCA1 and BRCA2.

In general, the chance of there being a family history link is greater when:

  • a number of family members have been diagnosed with breast cancer or related cancers, such as ovarian cancer
  • the family members are closely related to you
  • family members were diagnosed at a young age.

We have more information if you are worried about your risk of developing breast cancer because of your family history. Our section on cancer genetics also gives more information about family history of cancer.

Back to Breast screening

The breasts

Breasts are made of fat, supportive (connective tissue) and glandular tissue that contains lobes (milk glands).

Breast awareness

Knowing what your breasts normally feel and look like can help you to notice any changes early.