Frequently Asked Questions

Eligibility changes for high risk women Top

From July 16 2015, BreastScreen Victoria will implement eligibility changes for women who have a condition that may put them at an increased risk of developing breast cancer. This includes: Women with Atypical Ductal Hyperplasia (ADH), Atypical Lobular Hyperplasia (ALH) and Lobular Carcinoma in Situ (LCIS), Women with Symptoms and Women with a Personal History of breast cancer.

1. Why were these policies changed?

Top

The policies were reviewed in order to ensure BSV was in line with BreastScreen Australia (BSA) policy, recommendations of the BSA Evaluation and current clinical best practice.

2. Women with ADH, ALH and LCIS

Top

Current policy

  • Women with LCIS and ADH are eligible and reinvited for annual screening.
  • Annual re-invitation continues indefinitely.
  • Women are strongly encouraged to see their own doctor for annual clinical evaluation.

New policy

  • Women with LCIS, ADH and ALH are eligible for annual screening.
  • Annual reminder letters will not be sent after a woman is over 74 years of age although women can continue to return annually on request.
  • Women will be strongly encouraged to see their own doctor for annual clinical evaluation.

3. Women with Symptoms

Top

BreastScreen Victoria is not an appropriate pathway for women with breast symptoms such as lumps, nipple discharge, dimpling or pain.

However due to national policy, women with symptoms are eligible to attend the Program.

Current policy

  • Booking process does not ask about symptoms. If a woman mentions she has a breast symptom when booking an appointment, they are strongly encouraged to see GP rather than attend BSV, but appointment will be made.
  • Women receive standard routine two-view mammography of each breast.
  • All women with significant symptoms* are recalled to assessment.
  • Women with other symptoms: a results letter is sent to her and her GP requesting follow-up of the symptom.

*Significant symptoms are defined as a breast lump or nipple discharge that have been present for less than 12 months and which has not been seen by a GP.

New policy

  • Booking process will ask about significant symptoms*; women will be strongly encouraged to see GP rather than attend BSV, but an appointment will be made if the women insists.
  • Women will receive standard routine two-view mammography of each breast.
  • Only women with mammographic abnormalities will be recalled to assessment.
  • Women with symptoms will not be recalled to assessment if her screening mammogram is normal.
  • Results letters to the woman and her GP will requesting that she receives follow-up including clinical breast examination and further imaging as appropriate. Women with significant symptoms will also receive a reminder letter 4 weeks later to ensure she attends her GP for investigation of the symptom.

*Significant symptoms are defined as a breast lump or nipple discharge that have been present for less than 12 months and which has not been seen by a GP.

4. Women with a personal history of breast cancer

Top

Current policy

  • Women who have had breast cancer and breast conserving surgery (BCS) are not eligible for the Program.
  • Women who have had breast cancer and mastectomy are eligible for the Program but are discouraged from attending.
  • BSV will screen women who have been treated by mastectomy (with or without reconstruction) using routine two-view mammography of the unaffected breast.
  • BSV will not image the mastectomy flap or any reconstruction (regardless of method).
  • Only women with mammographic abnormalities are recalled to assessment.
  • Women are reinvited annually.
  • Women strongly encouraged to see own doctor for annual clinical evaluation.

New policy

  • Women who have had breast cancer and mastectomy OR breast conserving surgery (BCS) are eligible for the Program:
  • once it is five years since their date of diagnosis
  • If deemed appropriate by their treating team
  • Women previously diagnosed  by BreastScreen Victoria will not be reinvited from client base, it will be up to woman to re-enrol  after a minimum of five years since her diagnosis and with consultation with her treating team
  • BSV will screen women who have been treated by breast conserving surgery with standard routine two-view mammography of each remaining breast.
  • BSV will screen women who have been treated by mastectomy (with or without reconstruction)using routine two-view mammography of the unaffected breast.BSV will not image the mastectomy flap or any reconstruction (regardless of method).
  • Only women with mammographic abnormalities will be recalled to assessment for further investigations.
  • Annual reminder letters will not be sent after a woman is over 74 years of age although women can continue to return annually on request.
  • Women will be strongly encouraged to see own doctor for annual clinical evaluation.

5. Who was involved in the policy changes?

Top

An interdisciplinary Clinical Reference Group was convened to advise the review process. The members included Dr Jill Evans (State Radiologist VIC), Dr Warwick Lee (State Radiologist NSW), Ms Cathy Poliness (Surgeon), Mr Stewart Hart (Breast Surgeon and Surgical Oncologist) and Prof Bruce Mann (Breast Surgeon and Surgical Oncologist).

6. When will the policy changes be active?

Top

The policy changes are expected to take effect in July 2015.

7. I’m a GP or a practice nurse, what do I tell my patients about these changes?

Top
  • Alert women to changes in eligibility where appropriate (from July 16 2015)
  • Support women through assessment or with a diagnosis
  • Educate your patients on screening and early detection
  • Have BSV resources available in practice
  • Recommend screening for women 50-74
  • Use the PEN CS Clinical Audit Tool to highlight women due for screening
  • Add breast screening to suite of recalls.

For further information, please contact: policy@breastscreen.org.au