BreastScreen Aotearoa

BreastScreen Aotearoa is a free national breast screening programme that checks women for early breast cancer. The programme aims to reduce the number of women who die from breast cancer.

Who can have a free screening mammogram?

You can have a free screening mammogram every two years through BreastScreen Aotearoa if you meet all the following:

• are aged 45-69 years
• have no symptoms of breast cancer
• have not had a mammogram in the last 12 months
• are not pregnant or breastfeeding
• are eligible for public health services in New Zealand.*

If you meet the criteria above and have had breast cancer, you can re-enter BreastScreen Aotearoa five years from when your cancer was found.

* The Eligibility Direction describes the groups of people who are eligible for publicly funded (free or subsidised) personal health and disability services in New Zealand.  Details of eligibility are available at: www.moh.govt.nz/eligibility

What are the chances of getting breast cancer and dying from it?

• The risk of breast cancer increases as you get older. Of those women who get breast cancer, three-quarters are 50 years and over.
• Most women who get breast cancer have no close relative with the disease. Even among women with a family history of breast cancer, only a very small number will be at high risk of getting breast cancer.

The chance of a New Zealand woman getting and dying from breast cancer each year is shown in the table below. Because there are effective treatments available for breast cancer, most women who get breast cancer do not die from it.

What are the benefits of regular screening?

Screening does not stop you getting breast cancer but it does reduce your chance of dying from it.

If you are under 50, screening reduces your chance of dying from breast cancer by about 20%. If you are between 50 and 65, screening reduces your chance of dying from breast cancer by about 30%. For women aged 65 to 69, it is reduced by about 45%.

Chance of developing or dying of breast cancer

Source: NZHIS; data are averages for 1997-2002 (incidence) and 1996-2000 (mortality).

What should I know about mammograms?

Mammograms are breast x-rays. When you have a mammogram, the medical radiation technologist (radiographer) who takes the x-rays places each breast in turn between two plates on the x-ray machine. The plates hold the breast firmly for a few seconds while the pictures are taken. Many women find this uncomfortable, and a few find it painful. It does not harm the breasts.

How accurate are mammograms?

Like other screening tests, mammograms are not perfect.

A mammogram may suggest that something is not right when, in fact, all is well. This is called a false positive result.

You may notice symptoms of breast cancer between your two-yearly screening tests. This is called an interval cancer and can happen because:

• Some cancers do not show up on a mammogram. This is more likely in women before the menopause who often have dense breast tissue. The density usually reduces as women age and go through menopause.
• The radiologists (x-ray doctors) looking at the mammogram may miss the cancer. This will happen sometimes, no matter how experienced the radiologists are.
• Sometimes a fast growing cancer will develop.

Despite this, mammograms are the only proven way for finding breast cancers early enough to reduce your risk of dying of breast cancer.

Mammograms:

• can show changes in the breast before anything can be seen or felt. In most cases the changes will not be cancer
• can detect breast cancer early, which means a very good chance of successful treatment
• are particularly effective in women 50 years and over who have mammograms every two years
• can detect about 75% of unsuspected cancers in women under 50 and 85% in women over 50
• cannot prevent you getting breast cancer and cannot always prevent death from breast cancer
• are safe because only very small amounts of radiation are used in two-yearly screening.

What women aged 45 to 49 should know about mammograms

Regular mammograms reduce the chance of dying from breast cancer among women aged 45 to 69. However, the benefit is greatest for women aged 50 to 69 years for two reasons.

1. Breast tissue is denser in women under 50. This can make it more difficult to see a cancer. About a quarter of cancers in women under 50 years are not detected.

2. A false positive result is also more common in women under 50 and could lead to more unnecessary tests and anxiety.

What does BreastScreen Aotearoa offer?

The programme offers free screening mammograms to all women aged 45 to 69 who have no symptoms of breast cancer. Follow-up assessment is also free.

Screening is done every two years.

All BreastScreen Aotearoa facilities have to meet the BreastScreen Aotearoa National Policy and Quality Standards. These are independently checked. Monitoring reports are available to the public at www.nsu.govt.nz/Health-Professionals/1048.asp

After you have had your breasts screened, at least two radiologists will check your mammograms for breast cancer.

If you have had mammograms elsewhere, BreastScreen Aotearoa needs to see these to compare the results with your current mammogram.

What about my results?

The programme will send your results to you within two weeks of having your mammogram.

• For most women, the result will be normal and they will be asked to return for their next mammogram in two years.
• A small number of women will be phoned to come back because something needs further checking. This service, which is also free, may involve more mammograms, an ultrasound and perhaps the taking of a small sample of breast tissue for examination under a microscope. Most women recalled will not have breast cancer.
• The few women who do have breast cancer will be referred to a specialist for treatment. Most women with breast cancer will be advised to have surgery to remove the cancer. Some women will need further treatment such as radiation therapy, hormone
   therapy, chemotherapy or a combination of these.

If you notice any breast symptoms (changes that are not normal for you), see your doctor as soon as possible. Do not wait for your mammogram to have this problem checked. Possible signs of breast cancer are: a new lump or thickening  a change in breast shape or size  pain in the breast that is unusual  puckering or dimpling of the skin  any change in one nipple, such as:  - a turned-in nipple  - a discharge that occurs without squeezing  a rash or reddening of the skin that appears only on the breast.

How do I join BreastScreen Aotearoa?

If you are between 50 and 69 years and have been screened with BreastScreen Aotearoa before, you will get a letter inviting you for another mammogram with the programme. You can also make an appointment for yourself by ringing 0800 270 200. You should also ring this number if you have changed your address since your last mammogram.

All other women aged 45 to 69 who do not have breast symptoms can now register for the programme by ringing 0800 270 200.

Where are BreastScreen Aotearoa centres located?

The centres are located throughout New Zealand. They are wheelchair accessible.

Mobile screening units also travel around the country. Ring 0800 270 200 or visit www.breastscreen.govt.nz for more information.

Having your mammogram

• Don't use talcum powder, creams or deodorants on the day of your mammogram as these make cancers harder to find on the mammogram.
• Because you will need to undress from the waist up, wear clothing that is easy to remove, such as a blouse or jersey.
• A cape or gown will be available where you have your mammogram.
• Every care will be taken to ensure privacy when you have your mammogram.
• The radiographer will want you to be as comfortable as possible. Discuss any concerns with her.
• Bring any previous mammograms that you have.
• Bring your glasses if you need them for reading as you will need to fill in a form.
• You may bring a support person or member of your whanau with you.

The whole visit should take about 30 minutes.

The results of the mammogram will be sent directly to you. They will also be sent to your doctor if you have agreed to this.

Original material supplied by BreastScreen Aotearoa and reviewed by everybody, November 2009.