To screen or not to screen

I encourage women to attend their breast cancer mammogram appointments.  My screening detected my tumour and very likely saved my life.

Research has been published today by the All-Party Parliamentary Group for Breast Cancer (APPGBC) in their report entitled “A Mixed Picture: An Enquiry into Geographical Inequalities and Breast Cancer“.  Compiled by Breast Cancer Now, the report shows that, depending on where they live in England, some women are more than twice as likely to die from breast cancer under the age of 75.

Following a year-long inquiry (October 2016 – November 2017) by the APPGBC, which gathered evidence from NHS leaders, clinicians, patients and charities, the report found that while more women are surviving breast cancer than ever before, stark geographical inequalities exist across England in screening, early detection and access to treatment and services.

One of the findings that I find particularly surprising and troubling is the low take up of screening through routine mammograms.  The number of women attending screening appointments is inconsistent across the country.  Breast screening attendance has declined in all areas of the country except London over the past decade, with significant disparities across England.

The report found that screening uptake across England is now at its lowest rate in a decade, with the proportion being screened as low as 55.4% in some areas, compared to 82.3% in others.

All women aged 50-70 are invited for routine mammograms every three years as part of the NHS Breast Screening Programme. A major independent review in 2012 showed that NHS breast screening prevents 1,300 deaths from breast cancer each year, with around a third of all breast cancers in the UK being diagnosed through the Programme.

The report found that there are many reasons why women don’t attend screening appointments, including population demographics, such as deprivation, ethnicity, language barriers, unfamiliarity with screening, and taboos around breasts and cancer.  I’ve heard women say that they’ve skipped their appointments as they’re worried that the mammogram will hurt, frightened of what might be found on the x-ray or are just plain embarrassed about having to be topless.

For those of you who haven’t yet had a mammogram, here’s what happens.  After checking in, you wait for a little while (if you’re lucky!) and then get shown to a cubicle, remove your top clothes, and change into a gown.  After that, you enter the screening room which contains the mammogram machine.  A lovely female radiologist – well my two have been lovely – positions you in front of the machine and then manoeuvres your breast so that its on top of the x-ray machine.  This was easy for me due to the size of my breasts, but I understand that it can be more more tricky for those of you who aren’t so well endowed.  A clear plate is then lowered so that your breast is squashed between the two, and the picture is taken.  This procedure is then repeated for your second breast.  Each x-ray probably takes around 40 seconds of standing very still and was only very slightly uncomfortable for me.

All I can say is that if I had not gone to my screening appointment on January 6th 2016, I may not now be here to  write this blog.  It did cross my mind not to bother going to the mammogram as I’d had a clear result three years previously, but sense prevailed and I went along.

Of course nothing would show up on the mammogram I thought as I waited, a little nervously, in the mobile screening unit parked in the Community Centre car park in Croxley Green.  It seemed to me such a random place to hold mammograms – next to the community allotments, playing fields and behind the dental surgery at which I’d recently had a numerous fillings and root canal treatments.

I was in and out in under half an hour, but that half an hour changed the course of my life.  I was blithely unaware of the tumour that had been making itself at home in my left breast for who knows how long.  By the time that it was detected on the mammogram it was around 70mm and scattered throughout most of my breast.  BUT I COULDN’T FEEL IT OR SEE IT.  The only way that it was discovered was by me deciding to attend my screening appointment.

Since my diagnosis, I’ve felt lucky that I was called to screening at the time that I was.  Any later and the tumour could well have spread into my lymph nodes and beyond and my prognosis would have been a lot worse.  Luckily for me, the cancer was contained within my breast and all that I lost was that breast…… not my life!

What I’m trying to say in a very long winded way is…… when you get your breast screening appointment, please, please, please go to it.  Don’t be scared of the process or of what could be found.  The alternative could be much worse.






4 thoughts on “To screen or not to screen

  1. This is such a beautiful blog, Juliet! Your story and advocacy are really inspiring. I loved your Huffington Post article and have sent it to the American cousins. I remember the Mum of one of Sofia’s nursery friends making the same choice years ago. I never had a real heart-to-heart with her, and I don’t know know whether she had a connection with ‘Flat Friends’, but she looked amazing, as you do–very strong, beautiful, and confident. Lots of love from us!!!

    Liked by 1 person

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