The Facts

What we do Top

BreastScreen Victoria provides free screening mammograms, and follow up tests where necessary,  to find breast cancer early before any symptoms are noticed and when treatment is likely to be most successful.

For further information about screening for breast cancer, view the BreastScreen Australia BreastScreen and You booklet here.

 

 

Facts for women aged between 50 and 74 Top
  • 50% of women diagnosed with breast cancer are aged 50-74. This is the reason why a breast screening mammogram once every two years is primarily recommended for women in this age group.
  • Regular screening mammograms are the best way to find breast cancer early, before any symptoms are noticed and when treatment is likely to be most successful.
Facts for women aged between 40 and 49 Top
  • The tissue of younger women’s breasts is usually more dense than that of older women and can show up as white areas on the x-ray. Breast cancers also show up as white areas on x-rays. This makes breast cancer more difficult to detect in screening mammograms for women in their 40s compared to women aged 50-74.
  • While screening mammograms are primarily recommended for women aged 50-74, women aged 40-49 are still at risk of breast cancer and are welcome to have a free breast screening mammogram with BreastScreen Victoria every two years.
  • If you are unsure about your risk of breast cancer or whether breast screening mammograms should be a priority for you, we recommend that you talk to your doctor.
  • It is important for all women to know the normal look and feel of their breasts. If you notice any breast changes, nipple discharge or a lump, it is important that you visit your doctor as soon as possible, before you make an appointment at BreastScreen Victoria.
Facts for women aged 74+ Top
  • 50% of women diagnosed with breast cancer are aged 50-74. This is the reason why a breast screening mammogram once every two years is primarily recommended for women in this age group. However, women aged 74 and over are still at risk of breast cancer.
  • If you are over 74, you are outside the BreastScreen program’s target age range for screening (50-74) and therefore won’t receive letters from BreastScreen Victoria but you are still welcome to have a free breast screening mammogram with us every two years.
Family History Top

A family history of breast cancer means that one or more close relatives on the same side of the family have had breast or ovarian cancer.

A small proportion of women with a family history are at increased risk of developing breast cancer.

Approximately 4% of women are considered to be at moderately increased risk by having:

  • More than one family member on the same side of the family who have had breast or ovarian cancer.
  • One female or male first-degree relative (mother, father, sister or daughter) who has had breast cancer before the age of 50.

For many women, knowing that they have a family history of breast cancer is cause for concern. However, it is important to remember:

  • Most breast cancers are not caused by genetic factors.
  • Breast cancer is a common disease largely associated with ageing. Most women with a family history have the same risk of breast cancer as for any other woman in their age group.

If you have a close relative who has had breast cancer or you are concerned about your family history of breast cancer, it is important that you discuss your individual circumstances with your doctor.

Screening and Implants Top

Like other women aged 50–74, most women with implants can have a screening mammogram with BreastScreen every two years.

Minimal compression is used on the breast implant during the breast X-ray procedure. It is highly unlikely, but possible, that this compression could cause or worsen leaking of silicone or change the shape or texture of the breast.

Breast implants have a limited lifespan and their structure may gradually weaken with time. You should see your doctor for advice if you are concerned.

BreastScreen does not investigate or diagnose the conditions associated with breast implants. If you have concerns about your breast implants, please see your doctor before coming to BreastScreen.

Screening Benefits and Risks Top

It is important women have information to make informed decisions about their health. Weighing up the benefits and risks will help you decide whether a screening mammogram is right for you.

What are the benefits of breast screening?

  • Regular screening prevents deaths from breast cancer.
     
  • Breast screens can detect most cancers early–even before they can be felt or noticed.
     
  • If breast cancer is found early, it is more likely to be small, and successfully treated.
     
  • The earlier breast cancer is found, the better your chance of surviving it.

What are the potential risks of screening?

  • Having a screening mammogram means your breasts are exposed to a small amount of radiation. Current research shows that the benefits of having regular screening mammograms outweigh any possible risks from radiation.
     
  • Screening mammograms are not 100% accurate. This means that sometimes a woman’s screening mammogram may look abnormal, and she might be recalled for further tests. Most women who are called back for further tests do not have breast cancer. It also means that for a small number of women the screening mammogram might not find a breast cancer that is present.
     
  • Screening can find cancers which may not otherwise have been found in your lifetime. It is not possible to be sure which breast cancers found by screening will develop into a life-threatening cancer. Therefore, some women receive treatment that might not have been necessary in an effort to reduce their risk of a life-threatening cancer in the future.
     
  • Screening may cause some women to feel anxious or worried (e.g. about test results or follow-up tests).

Will a breast screen find all cancers?

Some cancers are not found on a screening mammogram. This can happen no matter how skilled the doctors reading the mammogram are. A very small number of women may be diagnosed with breast cancer between screening mammograms. If you notice any unusual breast change after your mammogram such as a lump, pain or discharge from the nipple, please visit your doctor without delay.

Does screening prevent breast cancer?

No. Screening only finds breast cancer if it is already there, but it can find cancers at an early stage.

Breast Density Top

Breasts are made up of a mixture of fibrous and glandular tissue and fatty tissue. Your breasts are considered dense if you have a lot of fibrous or glandular tissue but not much fat.

The tissue of younger women’s breasts is usually more dense than that of older women and can show up as white areas on the x-ray. Breast cancers also show up as white areas on x-rays. This makes breast cancer more difficult to detect in screening mammograms for women below 50.

 

Overdiagnosis Explained Top

BreastScreen Victoria provides women with up to date and evidence based information about the service.

Here, we explain overdiagnosis, which has been discussed recently in the media.

What is population screening?

In Australia, we have population screening for breast, bowel and cervical cancer. This means we aim to test everyone in a target group. For breast cancer, the target group is women aged 50–69 years. We know that women in this age group have a greater risk of breast cancer.

We encourage women aged 50–74 years to have regular mammograms. Having this test every 2 years means a cancer is more likely to be found early. Finding a cancer early, together with the right treatment, improves your chance of surviving breast cancer.

Does screening work?

A 2009 review of BreastScreen showed that population screening in women aged 50–69 years reduced deaths from breast cancer by 21–28%. Screening, combined with improved surgery and drug treatments, is saving lives.

Is there a downside to population screening?

A very small number of cancers do not lead to symptoms or death. People with these cancers won’t know they have cancer unless they are tested. A downside of population screening is that cancers that won’t go on to become a problem will be found and treated.

Treating a cancer that won’t become a problem is called ‘overdiagnosis’.

Is overdiagnosis harmful?

Some people say that diagnosing and treating cancers that won’t become a problem is harmful.

However, at the moment there is no way to know which cancers will become a problem (‘invasive’ cancers) and which won’t.

What can we do now?

Without treatment, breast cancer will usually lead to illness and death.

We welcome and encourage research that may soon help us to distinguish between invasive cancers and those that won’t cause later problems. In the future, a woman who finds she has a breast cancer that won’t become a problem may choose not to have treatment.

For now, regular 2-yearly breast screening is the best way for women to reduce their chance of dying from breast cancer.

Radiation and Mammography Top

BreastScreen is a free breast x-ray screening service for women over 50 with no breast symptoms. This statement answers some of the questions you may have about the safety of radiation during breast x-ray screening.

Radiation occurs naturally in the environment, for example, in solar cosmic rays that come from the sun. Science replicates (creates) this energy source, with extreme control and very specific features to suit it's desired purpose. In the form of x-rays, radiation allows us to view the inside of the body, so it is a very useful tool for seeing and diagnosing a range of conditions.

To date most studies of the potential risk of radiation have been undertaken on people exposed to a relatively high dose of radiation. These studies on survivors of atomic bombings, people who have worked with radioactive materials at the beginning of the 20th century and those exposed to radiation in early medical procedures do demonstrate a slightly increased risk of cancer in people.

While studies of the effects of exposure to high doses of radiation provide clear evidence of risk, these findings cannot easily be applied to the low dose radiation used in modern x-ray procedures. Using the data in these studies as a guide, researchers estimate that the theoretical risk of developing breast cancer from the relatively minimal radiation exposure during breast x-ray screening is extremely low if not zero. Radiation exposure received during breast x-ray screening is considered comparable to about three months’ exposure to naturally occurring radiation in the environment.

Why are mammograms considered important?

Mammograms are considered to be important because the benefit of detecting breast cancer early far outweighs the risk of harm from the x-rays. There are a few reasons for this.

Firstly, the dose of radiation used in screening mammography is extremely low. Breast tissue is easy for x-rays to penetrate and a small dose is sufficient to produce an adequate image.

Secondly, even at relatively high doses of radiation, risk of harm from radiation exposure is reduced considerably as we get older. Studies indicate that older women are less likely than younger women to develop breast cancer in situations of very high exposure to radiation and for women over 50 at the time of exposure there may be no risk at all.

All in all, the clear benefits of early diagnosis and treatment of breast cancer far outweigh the minimal risk of exposure to radiation during screening.

Quality control and minimising radiation at BreastScreen Victoria

BreastScreen Victoria understands the concern that many women feel about radiation exposure during medical examinations. We are committed to ensuring that the lowest possible dose of radiation is used in breast x-ray screening.

Standards for acceptable limits of radiation exposure are set at very low levels by the International Commission on Radiological Protection. The BreastScreen Australia National Accreditation Standards require that BreastScreen Victoria services meet relevant radiation protection regulations.

At each BreastScreen centre, staff routinely monitor the performance of the x-ray machines. In addition, the x-ray equipment is independently tested on a regular basis and a physicist checks the measurement of the radiation dose to ensure that it falls within the acceptable levels. Any problems are dealt with immediately.

Where can I get more information about radiation safety?

If you would like to know more about radiation safety and BreastScreen, please contact the BreastScreen Victoria Coordination Unit on (03) 9660 6888 or email info@breastscreen.org.au.

This statement was last reviewed in March 2012 in consultation with J.C.P.Heggie, Consultant Medical Physicist to BreastScreen Victoria.

Thyroid Shields Top

Media reports have highlighted concerns that the small amount of radiation from a mammogram may significantly increase the likelihood of developing thyroid cancer. These concerns are not supported in scientific literature.
 
Women should not be deterred from having regular screening mammograms as the thyroid is not exposed to the direct X-ray beam used to image the breast. The radiation dose to the thyroid is also incredibly low.

BreastScreen Victoria does not endorse the use of thyroid guards during screening.
 
Our mammography machines are annually checked by medical physicists to ensure safety and performance standards as specified by the Royal Australian and New Zealand College of Radiologists and the Victorian Government Regulations. For more information refer to: http://www.aapm.org/publicgeneral/LeadApronsMammographyResponse.asp
 
The BreastScreen Victoria program saves women's lives as regular screening mammograms are the best way to find breast cancer early, when treatment is likely to be most successful.