A breast screen is a screening mammogram (a low dose X-ray of the breast), for women who have no breast symptoms such as a lump, nipple discharge, or change in the breast that is unusual.

Screening mammography involves taking at least two images of each breast - one from the top and one from the side. It is currently the most effective screening test for undetected breast cancer.

If a woman has a breast symptom, she may need a diagnostic mammogram. A diagnostic mammogram involves more detailed images of the breast to allow doctors to assess the symptom. Some cancers do not show on a mammogram, so other detailed tests may be needed.

This is why breast screens are only appropriate for women who have no breast symptoms.

BreastScreen SA invites women aged 50 to 74 to have a breast screen every two years. Evidence suggests regular screening is most effective in this age group.

Women aged 40 to 49 and over 75 years can also make an appointment for a free breast screen, but are strongly encouraged to speak with their doctor when deciding if breast screening is right for them.

Breast screening is not an effective screening test for women under the age of 40. While breast cancer can occur at any age, it is much less frequent in women under the age of 40.

Women who have a strong family history of breast cancer can have a breast screen every year from the age of 40.

For information on screening for different age groups and for strong family history information, click here.

Some women may need different care and services that are not part of screening.

This includes women who:

• have breast symptoms (such as a lump, nipple discharge or change in their breasts)
• have a strong family history of breast and/or ovarian cancer
• have a previous diagnosis of breast cancer within the last five years
• have restricted upper body movement or have difficulty holding or supporting their own weight.

Speak with your doctor or phone BreastScreen SA on 13 20 50 to make sure you receive the most suitable care and service for you.

BreastScreen SA has 8 fixed clinics within the Adelaide metropolitan area, and 3 mobile screening units that visit rural, remote, outer-metropolitan and some metropolitan areas every two years. Locations of our fixed clinics are listed on the back of this booklet, and a wider list of locations can be found here.

You can call BreastScreen SA on 13 20 50 to make your appointment between 8.30am and 5pm. Please note that we will need to ask you a number of personal health questions when you book, so please make sure you have the time and the privacy to answer those when you call.

Alternatively, you can book online here.

Please arrive 10 minutes early to your appointment to give yourself plenty of time to complete your consent form and to ask questions. Please also remember to bring your Medicare card with you.

One of our friendly receptionists will check your full name, date of birth and address details with you to ensure they are correct and that we are screening the right person. A specialist female radiographer will then take you into the screening room and you will need to undress from the waist up. You can drape your shirt or cardigan over your shoulders if you wish, or disposable gowns are available upon request.

When you are ready, the radiographer will place one breast at a time on to the mammography machine. The machine will firmly press on your breast for 10-15 seconds to take the image. Usually two images of each breast are taken, one from the top and one from the side. Women with larger breasts may need additional images to ensure all the breast tissue can be seen. Once your images are taken, you’ll be able to get dressed and your appointment will be finished.

Your images are not read at the time of your appointment. The radiographer performing your mammogram will check your images for technical quality. Your images are then sent to our State Coordination Unit in Adelaide where they will be read by at least two specialist radiologists.

Many women are concerned that a breast screen will be painful. The truth is every woman is different. Some say it’s uncomfortable, some say it’s a little painful, and other women report that it’s absolutely fine. If you feel discomfort it should only last a few seconds. This is because your breasts need to be compressed firmly in the X-ray machine so that a clear image can be taken. If you do find it too painful, you can stop the procedure at any time. Please speak with the radiographer during your appointment if you are concerned.

Each time you have a mammogram, you are exposed to a very small dose of radiation. Mammography units use the smallest dose of radiation possible to take a high-quality image. The dose is similar to many other common X-rays people have, and is further minimised by the compression of the breast. Research shows that the benefits of breast cancer screening outweigh the radiation risks.

After your breast screen, your images will be read by at least two independent radiologists. Depending on their findings, you will be given one result: either ‘no evidence of breast cancer’ or ‘recall for further tests’.

Your results are usually posted to you and your nominated doctor within 14 days of your appointment. As this test only looks for breast cancer, any non-cancerous (benign) changes are not reported on.

Around 5% of women screened will be asked to come back to BreastScreen SA for more tests. This does not mean that you have breast cancer, but sometimes more tests are needed to make sure. This happens more often for women having their first breast screen, as there are no previous mammogram images to compare with. Something that might look unusual on your first mammogram might be completely normal.

Women are invited back to our dedicated Assessment Clinic in Adelaide, where they will have tests, which may include more detailed mammography, ultrasound, a clinical breast examination, and in some cases a biopsy. This can be a very anxious experience and our specialised team of health professionals will ensure you are as comfortable as possible during your visit.

Most women who have further tests are reassured they do not have breast cancer. They are then reinvited for their next breast screen when it is due.

A small number of women (less than 1% of all South Australian women screened) will receive a diagnosis of breast cancer after their Assessment Clinic appointment. Our specialist team of health professionals will guide you through this process and explain what will happen next.

While BreastScreen SA does not treat women for breast cancer, we will help you arrange your future care needs by contacting your doctor. Your doctor will discuss your specialist referrals, treatment and follow-up choices with you.

For more information about breast cancer, you can visit the Cancer Australia website.

There are a number of factors that can increase your individual risk of developing breast cancer. These include personal factors such as being female, your age, if you’ve had a previous diagnosis of breast cancer, your individual breast density and your family history. Others are lifestyle factors such as your diet, how often you exercise, if you smoke or regularly drink alcohol. If you want to assess your risk, you can speak with your doctor or use the following online questionnaire at www.breastcancerrisk.canceraustralia.gov.au.

A woman’s breast is made up of both fatty tissue and fibroglandular tissue (non-fatty) tissue. On a mammogram, fatty tissue appears black while the remaining breast tissue appears white or ‘dense’. The relative amount of fibroglandular tissue (white areas) on a mammogram is referred to as breast density.

As breast cancers also appear as white areas on a mammogram, high breast density reduces the sensitivity of screening mammography. Despite this, screening mammography is still the best population-based breast cancer screening test for women aged 50 to 74, including those with dense breasts.

Dense breasts are common and normal occurring in about 40% of women over 40 years of age.

Your breast density will be reported with your breast screen results.

Click here for more information about breast density.

Finding breast cancer at an early stage

In 2008, local research found that South Australian women aged 50 to 69, who had a breast screen every two years, reduced their chance of dying from breast cancer by up to 41%.*

Less invasive treatment

For every 1000 women who have a breast screen, only 6 women will be found to have breast cancer. Breast cancers that are detected through BreastScreen SA are generally smaller, making them simpler and easier to treat. A woman's overall health outcome is also improved.

Reassurance

Most women who have a breast screen will get a result of ‘no evidence of breast cancer’ and will feel reassured they are being proactive in maintaining their breast health.

While screening mammograms are currently the most effective way for screening for breast cancer, there are limitations you need to be aware of.

Breast cancer is present but not found

A screening mammogram will not detect all breast cancers. Some cancers cannot be seen on a screening mammogram or can develop during the time between mammograms. There is a small chance that a cancer could be missed on a screening mammogram. This may lead to a diagnosis of breast cancer at a later stage.

Less than 1 in 1000 women aged 50 to 74 will be found to have breast cancer in the 12 months following their breast screen.

Other factors contributing to the effectiveness of screening mammograms can include a woman’s age and her individual breast density.

Breast cancer is found and treated unnecessarily (overdiagnosis)

Breast screening may also find breast cancers that may potentially not become life-threatening. This means a woman may elect to be treated for a cancer that may never be harmful to her, however the treatment itself may cause her harm.

It is not yet possible to tell exactly which breast cancers may become life-threatening and which may not.

Further tests are done, but breast cancer is not found

If an area of concern or a change in your breast tissue is found on your screening mammogram, you will be called back to BreastScreen SA’s Assessment Clinic for further tests. These tests will include further mammography ultrasound and possibly a clinical breast examination or biopsy. While this may be an anxious time for women, most will be reassured they do not have breast cancer.

Even if you have two-yearly breast screens, it is still important to be breast aware because breast cancer can develop at any time. This includes the time in-between screening appointments.

It is important to know the normal look and feel of your breasts. Things you should look for include:

• a new lump or lumpiness in your breasts, especially if it is in only one breast
• a change in the size and shape of your breast
• a change to the nipple such as crusting, an ulcer, redness or the nipple pulled in
• a discharge from your nipple that happens without squeezing the nipple
• a change in the skin of your breast such as redness or dimpling or puckered skin
• a pain that does not go away.

Most breast changes will not be due to breast cancer but you should get them checked to be sure. If you notice a change in the look or feel of your breasts, even if your last screening mammogram was normal, see your doctor without delay.

Please don’t wear talcum powder or deodorant on the day of your appointment as it may affect your breast screen.

• Wear a two-piece outfit as you will be required to remove your bra and top during the breast screen.
• Please remember to bring your Medicare Card with you to your appointment, as well as your completed and signed consent form.
• Please arrive 10 minutes before your appointment time so we can process your paperwork.
• If you have had a mammogram elsewhere, please let our staff know at the time of booking your appointment.
• If you have any questions please ask our friendly staff.

Cancer Australia

www.canceraustralia.gov.au

Breast cancer risk calculator

breastcancerrisk.canceraustralia.gov.au

Australian Institute of Health and Welfare

www.aihw.gov.au