Breast screening is a test for breast cancers that are too small to see or feel.
Breast cancer is the most common cancer in women and people assigned female at birth (AFAB). About 1,000 women and AFAB people die of breast cancer every year in Scotland.
Breast screening doesn't prevent cancer, but can detect cancer early and reduce the number of women and AFAB people who die from it.
If you have symptoms of coronavirus (COVID-19), or have been in contact with someone who does, call the number on your invitation to rearrange your appointment.
Non-urgent advice: Speak to your GP if you experience:
- a lump or area of thickened tissue in either breast
- a change in the size or shape of one or both breasts
- discharge from either of your nipples (which may be streaked with blood)
Most breast lumps (90%) aren't cancerous, but it's always best to have them checked by a medical professional.
Who'll be screened?
In Scotland, breast screening is routinely offered to those who:
- are female
- are between 50 and 70 years old
- have not had breast screening in the last 3 years
Breast screening is also offered to:
- non-binary people who were assigned female at birth (AFAB), and haven't had breast removal surgery
- trans women who are taking hormones
- trans men who haven't had breast removal surgery
Why aren't people under 50 screened?
Screening isn’t offered to younger women and AFAB people because:
- the chance of developing breast cancer increases with age
- the test is most effective in women and AFAB people who've reached the menopause
Why aren't people over 71 routinely screened?
Women and AFAB people aged 71 and over are not routinely invited for breast screening. There isn’t clear evidence that the benefits of screening people in this age-group outweigh the potential risks of harm. For example, diagnosing and treating a breast cancer that would otherwise not cause harm within a person’s lifetime.
Self-referral for breast screening
Certain people can self-refer for breast screening. If you're aged 71-74 years old, or have previously had breast cancer and have been discharged from yearly follow up mammograms, you can self-refer for a breast screening appointment.
To self-refer, contact your local breast screening centre.
Your screening invitation
You should be invited for breast screening by your local breast screening centre.
GP practices only take part in the breast screening programme every 3 years, so you may not get your first invitation until you're 53.
Contact your local screening centre if you:
- haven't had your first invitation by your 53rd birthday
- have moved house or GP practice and not had an invitation in the last 3 years
Text message reminder service
If you'd like to receive a text message reminder about your breast screening appointment, please make sure your local breast screening centre has a record of your current phone number.
When to contact your local screening centre
If you decide to take up the invitation, contact your local screening centre as soon as possible if you:
- want to have someone else with you during the scan for support, as mobile screening units may not have room for additional people
- have a disability
- need an interpreter or any other help
- have any concerns or want to discuss anything about your appointment
- want to check they have your phone number for text message reminders about your appointment
You should also contact the screening centre if you:
- have breast implants
- have had breast cancer
- have had a mammogram within the last 6 months
Benefits and risks of breast screening
As with any test, there are benefits and risks involved in breast screening. It’s important that you’re aware of these before accepting a screening invitation.
Breast screening can find breast cancer before any symptoms become noticeable. The earlier breast cancer is found, the less treatment is needed and the better your chance of survival.
Screening saves lives from breast cancer, but it does have some risks:
- some people will be diagnosed and treated for breast cancer that wouldn't otherwise have been found or caused them harm
- a small number of cancers may not show up on the breast X-ray (mammogram)
It’s important that you repeat the screening test every 3 years. You should also regularly check your breasts for any symptoms of breast cancer, like a lump or swelling in your breasts or armpits, or changes in your nipple.
The X-ray used in breast screening can cause breast cancer, but this is rare.
For every 14,000 people screened regularly for 10 years, 1 may develop breast cancer because of this radiation.
Choosing not to be screened
If you decide not to take the test, you should let the screening centre know in plenty of time.
You'll be invited for screening again in 3 years. If you don't want to be invited again, ask the screening centre for a disclaimer form so that your name can be removed from the system.
If you've completed a disclaimer or decided not to be screened at this time, but change your mind later, you can arrange an appointment by contacting your local screening centre.
What happens during your breast screening appointment?
Taking the test
The breast screening test involves taking images of your breasts using an X-ray (mammogram) and checking them for changes.
The breast screening test is done by female health professionals only.
You'll have the test at your nearest breast screening centre, or mobile screening unit. Your appointment will usually take no more than 30 minutes.
Before the test
When you arrive for your appointment, the mammographer will check your details and explain the test to you. You'll have an opportunity to ask questions.
You should wear a loose fitting top as the mammographer will ask you to undress from the waist up. You can cover up when you're not having the mammogram.
You shouldn't use talcum powder or spray deodorant before the test.
A less common side effect of the coronavirus (COVID-19) vaccine is swollen glands in the armpit or neck on the same side as the arm where you had the vaccine. If you’re due for breast screening please mention that you’ve had your vaccine when you attend. There’s no need to delay your appointment.
During the test
Your mammographer will X-ray one breast at a time. To do this she'll:
- position your breast between 2 special plates on the mammogram machine
- press the breast firmly between the plates for a few seconds
- take 2 pictures of each breast — you should stay as still as possible while she takes the pictures
A mammogram only takes a few minutes.
The screening centre will keep your mammograms for at least 9 years.
Your mammograms could be used for:
- quality assurance
They'll remove your personal information before sharing your mammograms.
You'll usually get the results of your breast X-ray (mammogram) by letter within 3 weeks. Your GP will also get a copy of your results.
You'll receive 1 of 3 results:
- negative result
- positive result
- inconclusive result
If you haven't received your results within 3 weeks, please contact your local screening centre.
Most people who take the test have a negative result, which means:
- no changes were found in their breasts
- there’s no signs of breast cancer
If this is the case:
- you won’t need any further investigations or treatment
- you'll be invited to be screened again within 3 years
If you notice any changes in your breasts before your next screening appointment, contact your GP practice.
About 5 out of 100 people who take the test have a positive result. This means the test found changes in the breast that need investigating.
If you have a positive result, the screening centre will invite you for further tests. This can include:
- a breast examination
- more mammograms
- an ultrasound scan
Some people will also need to have a tissue sample taken for testing. This is called a biopsy.
Positive for breast cancer
The results of these tests can lead to a breast cancer diagnosis. If you test positive for breast cancer, you'll be referred to a team of breast cancer specialists for treatment.
Only 1 in 5 people that have further tests will have breast cancer.
If your mammogram isn't clear or of a good enough quality, they'll arrange an appointment for you to have further X-rays. This is called a technical recall, and can happen if breast tissue was missed or moved during the test.
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