The Facts

What we do Top

BreastScreen Victoria provides free 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 read Is BreastScreen for you?

Facts for women aged between 50 and 74 Top
  • 50% of women diagnosed with breast cancer are aged 50-69. This is the reason why a breast screen once every two years is recommended for women in this age group.
  • Regular breast screens 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 breast screens for women in their 40s compared to women aged 50-74.
  • While breast screening is recommended for women aged 50-74, women in their 40s and over 74 are encouraged to discuss the benefits and risks of screening in the context of their individual health needs with their doctor.
  • If you are unsure about your risk of breast cancer or whether breast screening 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 under 40 Top
  • Women under 40 have dense breast tissue which makes it difficult for breast screens to accurately detect breast cancer. As research has not provided evidence that breast screening reduces deaths in this age group, women under 40 are not eligible to attend BreastScreen Victoria. Women should see their doctor if they have any breast changes.

Facts for women aged 74+ Top
  • 50% of women diagnosed with breast cancer are aged 50-69. This is the reason why a breast screen 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 eligible to have a free breast screen with us every two years. BreastScreen encourages you to speak to your doctor to determine whether breast screening is suitable for your individual health needs.
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 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.

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 before making an appointment with BreastScreen.

Download the Family History fact sheet for further information.

Signs and symptoms of breast cancer Top

BreastScreen is for women who don’t have any breast symptoms. If you have an unusual change in your breast such as a lump, nipple discharge or pain we suggest you see your doctor to ensure you receive the most appropriate care.

For more information read our Signs and symptoms of breast cancer fact sheet.

Screening for women with a past history of breast cancer Top

If you were diagnosed with breast cancer more than five years ago you are able to have annual breast screens with BreastScreen Victoria with the approval of your treating doctor.

For more information read our BreastScreen: Information for women previously diagnosed with breast cancer fact sheet.

LCIS and atypical hyperplasia Top

Some benign (non-cancerous) breast conditions mean you may have a higher risk of developing breast cancer. These include:

  • Lobular carcinoma in situ (LCIS)
  • Atypical ductal hyperplasias(ADH)
  • Atypical lobular hyperplasia (ALH)

In these conditions, the cells in the breast lobules or ducts become abnormal in shape and size and begin to multiply. If you are diagnosed with LCIS, ALH or ADH this does not mean that you have breast cancer. However, having one of these conditions increases your risk (chance) of developing breast cancer.

Because of the increased risk of breast cancer, you will need more frequent screening including an annual breast screen of both breasts and an annual physical examination of your breasts by your doctor.

For more information read our fact sheet Lobular carcinoma in situ and atypical hyperplasia of the breast.

Pregnancy and breastfeeding Top

Pregnancy

Women who are pregnant are not eligible to have a breast screen with BreastScreen Victoria. This is because of the potential radiation risks and harm to your baby.

If you are concerned or notice any changes in your breasts, you should contact your doctor without delay.

Breastfeeding

If you are breastfeeding you are not eligible to have a breast screen with BreastScreen Victoria until six months after you have stopped breastfeeding.

This is because breast cancer screening is less effective on the breasts of women who are breast feeding. The breast tissue of breast feeding women is dense with stored milk. On a breast screen, dense breast tissue shows up as a solid white area. Breast cancers, which also show up white, may be difficult to detect.

If you are concerned or notice any changes in your breasts, you should contact your doctor without delay.

Screening and implants Top

Most women who have breast implants can have regular breast screens every two years. Before making an appointment you may wish to discuss with your doctor whether breast screening is suitable for you.

Please advise our staff that you have breast implants when you make your appointment.  Implants make it harder to see breast tissue on a standard breast screen. Additional images will be needed to show as much breast tissue as possible. You will also need a slightly longer appointment (approximately 20 minutes).

Implant problems are not assessed by BreastScreen Victoria. If you notice a problem with your implants please see your doctor as soon as possible.

Breast screening is generally safe for women with implants. However, like for every woman, it is important that you consider the risks alongside the benefits before deciding to attend BreastScreen.

Download the Implants fact sheet for further information.

Why are regular breast screens so important? Top

Finding breast cancer early before any symptoms are noticed, and when treatment is most likely to be successful gives women the best chance of survival.

A regular breast screen, every two years, is the best way to find cancer early.

9 out of 10 women diagnosed with breast cancer have no family history of the disease. While women with a strong family history of breast cancer have a higher than average risk, the biggest risk factor for breast cancer is being a woman over the age of 50.

Remember, once is not enough. The best way to detect changes in the breast is to compare your previous X-rays with a current breast screen.

Download the It's Time For Your Next Breast Screen brochure for further information.

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 breast screening 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 breast screen means your breasts are exposed to a small amount of radiation. Current research shows that the benefits of having regular breast screens outweigh any possible risks from radiation.
     
  • Breast screening is currently the most reliable means of detecting breast cancer but it is not perfect. There is a small chance that a breast screen will look normal, even if a breast cancer is present. A very small number of women are diagnosed with breast cancer between breast screens. Some women will be called back for more tests after a breast screen because the X-ray picture showed an abnormality. Most women who are recalled will not have cancer.
     
  • Some women who have screening will be diagnosed and treated for breast cancer that would never have caused them harm. This is known as overdiagnosis. As we cannot tell which breast cancers may become life threatening, all women diagnosed with breast cancer are offered treatment.
  • 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?

  • Breast screening is currently the most reliable means of detecting breast cancer but it is not perfect. There is a small chance that a breast screen will look normal, even if a breast cancer is present. A very small number of women are diagnosed with breast cancer between breast screens.
  • If you have noticed an unusual change in your breasts such as a lump, pain or discharge from the nipple, it is important that you visit your doctor as soon as possible.

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.

For further information about screening for breast cancer, read BreastScreen Australia's BreastScreen and You brochure.

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.

Australian and international researchers have been investigating breast density for many years but there is currently no consistent way to measure it.

BreastScreen Australia supports research, greater discussion, and public awareness of breast density, and has released a Position Statement on breast density and screening.

The Royal Australian and New Zealand College of Radiologists has also released a Postion Statement on breast density.

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 50–74 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 breast screens. 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 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 life-threatening 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.

Where can I find out more?

Cancer Australia position statement.

BreastScreen Australia national consumer information brochure.

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 its 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 breast screens important?

Breast screens 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 breast screen 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 breast screen 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 breast screens are the best way to find breast cancer early, when treatment is likely to be most successful.

Breast tomosynthesis (3D mammography) Top

Breast tomosynthesis (3D mammography) has been approved for screening and diagnosis of breast cancer.

Tomosynthesis can be of benefit in an assessment setting, however, more evidence is needed before tomosynthesis can be considered for possible implementation in the BreastScreen Australia program for population screening of well women.

As currently recommended, having a free mammogram every two years with BreastScreen Australia will give women the best chance of detecting and surviving breast cancer.

The Standing Committee on Screening will continue to monitor and analyse the emerging evidence. 

What is breast tomosynthesis?

Breast tomosynthesis (3D mammography) is a new digital mammography technology that is in the testing and clinical evaluation stages for its possible benefits in screening and assessment.

Tomosynthesis uses a modified digital mammography unit to create 3D images.

Currently, BreastScreen Australia uses 2D (two-view) digital mammography as the primary test to screen women for breast cancer.

Why doesn’t BreastScreen Australia use tomosynthesis in the routine screening process?

There is scientific evidence that tomosynthesis may be of benefit  to assist with a definitive diagnosis for women whose routine 2D mammograms have shown they could have breast cancer.

There is currently insufficient scientific evidence for the benefit of tomosynthesis as a replacement for 2D mammograms, as the routine screening test for population screening of well women. Population-based screening is where a test is offered systematically to all individuals in a defined target group as part of an organised program.

We do not yet have a clear picture of the benefits and costs of using breast tomosynthesis for population screening generally within the BreastScreen Australia service.

Any new technologies for breast cancer screening must meet the Australian criteria for population screening as outlined in the Population Based Screening Framework.

In October 2014, the Standing Committee on Screening (SCoS), the national body that provides policy advice on screening to all Australian Governments endorsed a Position Statement on the use of Tomosynthesis within BreastScreen Australia services which recommends that, based on current evidence, the use of tomosynthesis as a screening technology in BreastScreen Australia be confined to clinical trial settings.

2D digital mammography remains the most effective screening test at this time. Tomosynthesis can be of benefit in an assessment setting.

The results of further Australian clinical trials are needed before the technology could be recommended for routine population screening. Clinical trials are research studies essential for evaluating if a drug, device, service or intervention is safe and effective.  

Women should continue to feel confident that having a free mammogram every two years with BreastScreen as recommended, will give them the best chance of detecting and surviving breast cancer.

Are some states and territories already using of tomosynthesis as part of BreastScreen Australia services?

Jurisdictions are gathering evidence on tomosynthesis for breast screening but BreastScreen Australia will make a national decision on its use in the BreastScreen program.

Have other countries rolled out tomosynthesis for population screening?

Australia is aware of one other country that has recently begun the use of tomosynthesis for population screening.

However, population screening programs in different countries are not identical and we need to be confident that tomosynthesis is appropriate in an Australian population screening setting before we can consider introducing it.

What kind of radiation does tomosynthesis deliver?

Tomosynthesis/3D Mammography delivers Ionising radiation. The amount would vary depending on how and when tomosynthesis was used and may be higher compared to 2D mammography although the evidence remains unclear. (i) (ii) A higher radiation dose will occur when using 2D and 3D mammography together and this needs to be considered compared to the potential benefits for people who receive this level of screening.

The radiation dose is safe and well within Australian guidelines and would be comparable to the amount of radiation that a person would receive when flying from Australia to London and back.

[i] Dance DR, Strudley CJ, Young KC, et al. Comparison of breast doses for digital tomosynthesis estimated from patient exposures and using PMMA breast phantoms. In: Maidment AD, Bakic PR, Gavenonis S (eds) Proceedings of the 11th international conference on breast imaging (IWDM 2012). Berlin: Springer; 2012, 316‑321.

[ii] Skaane P, Bandos A & Gullien R. Comparison of Digital Mammography Alone and Digital Mammography Plus Tomosynthesis in a Population-based Screening Program. Radiology: Published online before print & January 2013.

 

Screening for women with disabilities Top

BreastScreen Victoria provides free breast screening for women aged 50-74 every two years. We are committed to equal access for women with disabilities.

See a video about Tricia’s experience.

Click here for more information

Overcoming the barriers - a cancer screening tool for disability workers and carers

This is an online learning tool aimed at supporting people with an intellectual disability so that they can better access cancer screening. The learning modules provide information for disability workers and carers on breast, pap and bowel screening. The online modules were a collaborative effort between, BreastScreen Victoria, Centre for Developmental Disability Health Victoria Cancer Council Victoria and PapScreen Victoria. 

Click here for more information.