4. BREAST CANCER SCREENING

Abstract

SUMMARYMammographic screening reduces breast cancer mortality by 24% in women aged ≥50 years. Women aged 50–53 are invited for their first screen in the National Health Service Breast Screening Programme (NHSBSP), thereafter at three‐year intervals until the age of 64. Two‐view mammography is offered at the first (prevalent) screening examination and one‐view for subsequent (incident) screens. The screening films are sorted into either ‘normal’ or ‘abnormal requiring further assessment’. Assessment is carried out by a specialist multidisciplinary team using the triple approach: clinical examination, imaging and, where appropriate, needle biopsy. Imaging is planned according to the mammographic abnormality – paddle compression view to assess parenchymal distortion, magnification view to assess microcalcification. After confirmation of a suspicious abnormality, needle biopsy is performed. Results of triple assessment are considered together by the multidisciplinary team and further management is planned. There are four likely outcomes: benign/normal, confirmed breast cancer, suspicious but needing diagnostic surgical excision, and diagnostic uncertainty needing early recall for screening.