What exactly happens during a mammogram?
Kelly Hoppen has urged women not to put off their mammograms, revealing her breast cancer diagnosis came after eight years of avoiding screenings.
The former Dragons Den investor and designer, 63, who learned just last month she is cancer-free, now feels compelled to share her story to encourage others not to skip their breast health checks.
Appearing on Monday's episode of This Morning – after writing about her personal experience in the Daily Mail – Hoppen said, "I'm a really sensible woman but I had the fear of god in going and getting tested for more than eight years.
"I kept putting it off."
After "suddenly" deciding to go, despite not having any symptoms, she was diagnosed with Ductal Carcinoma In Situ (DCIS).
Hoppen had the cancer cells removed, as well as the tissue around it.
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She's sharing her story to urge women to attend their breast screenings.
"I can't be the only person that feels this way," Hoppen said.
"I knew that if I went [to a mammogram] and I was checked and they found something they would be able to do something, but I still didn't go – like a child, I didn't want to know."
Missing mammograms
There are nearly 56,000 new cases of breast cancer each year, according to Cancer Research UK. While this might seem daunting, there is also a 76% survival rate, with a good chance of recovery if it's diagnosed early enough.
All women who are 50-70 years-old are invited by the NHS to a free breast cancer screening every three years (those over 70 can also arrange an appointment through their GP or local screening unit), to help boost early detection.
As well as attending routine mammograms, checking for symptoms yourself can also help with alerting your doctor and spotting early signs.
But concerns about the procedure, along with COVID disruption saw a 44% fall in the number of women screened for the disease nationally in 2020-21 according to NHS England.
Screening is vital in helping the NHS identify cancers at an earlier stage and in 2021-2022 the NHS breast screening programme led to cancers being detected in 20,152 women across England, which otherwise may have been diagnosed and treated at a later stage.
New national figures on Cancer Survival in England, show that 91% of women diagnosed at an early stage of breast cancer, where the tumour is small (stage 1), have a survival rate of at least five years.
In comparison, the five-year survival rate for diagnosis at a late stage, where the cancer has spread to other parts of the body (stage 4), is 39%.
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According to Healthtalk.org there are various reasons some women are choosing not to attend their mammogram, ranging from being too busy to being deterred by a fear of pain or discomfort during the screening appointment.
"Some women choose not to go because they feel fit and healthy and do not think they are at risk of developing breast cancer," the charity continues. "Studies suggest that a few women don't go for screening because they are afraid of being diagnosed with breast cancer.
"Other research has found that some women are put off going if they've had a 'false positive result' – one where something is seen on the mammogram but this turns out not to be cancer.
"Being referred to a breast clinic for further tests after a screening can be worrying and can deter women from attending in future," the charity adds.
What is a mammogram?
Breast screening (often referred to as a mammogram) is a breast health check.
"NHS breast screening uses a mammogram, which is an x-ray test, to spot cancers at an early stage when they’re too small to see or feel," explains Professor Cliona Kirwan, chair of Prevent Breast Cancer’s scientific advisory board. "Breast screening can pick up breast cancer before there are signs or symptoms."
Who can get a mammogram?
In England, breast screening is offered to all women aged 50 to 70. "Mammograms tend to be less effective for women under 40, as younger women’s breast tissue can be more dense, which makes it harder to spot changes in the x-ray images," Professor Kirwan explains.
However, if you have a strong family history of breast or ovarian cancer, or have been found to have an increased risk of cancer, you may be eligible for screening before the age of 50.
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What is involved in a mammogram?
If you’re going for your first-ever mammogram, it’s normal to feel a bit apprehensive about it. "Many women worry about the potential pain or associate the scan with a breast cancer diagnosis – which can be enough for some to skip the screening altogether," Professor Kirwan explains.
While it is fair to say some women do find the screening uncomfortable, the appointment itself will only take around half an hour and it’ll be over before you know it.
"It’s a good idea to wear loose, comfortable clothing, as you will need to undress to the waist," Professor Kirwan advises. "It’s also worth skipping deodorant on the day of your scan as images are also taken under your armpits and having aluminium around that area can affect the results."
You may be asked to complete a questionnaire about your medical and family history, if you have had previous breast surgery, including breast implants, and if you are having hormone replacement therapy (HRT).
Your mammogram will be taken by a female practitioner who will place your breasts one at a time on an x-ray machine and compress them each for a few seconds. Pictures of the breasts will be taken from different angles, including the part around the underarms.
Will it hurt?
Although it may be uncomfortable, Professor Kirwan says it will only last a few seconds and isn’t harmful.
"It may not be the most pleasant procedure, but going for a mammogram will provide peace of mind and can also catch breast cancer at an earlier stage, making it more treatable," she adds.
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Mammogram misconceptions
Some people are concerned that the x-rays themselves can cause breast cancer, due to the radiation (measured in millisieverts) associated with mammograms. This risk is however very low.
"A mammogram is 0.4 millisieverts," explains Professor Kirwan. "To put this in context, we are exposed to about 3 millisieverts just from the atmosphere alone each year, and so a mammogram is an eighth of what we’re exposed to annually.
"In theory, a mammogram can cause breast cancer, but we find about 600 times more cancers, than are caused by breast screening, and so many, many more lives are saved from breast screening," she adds.
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How long will it take to get my mammogram results?
You should expect to receive your results no later than two weeks after your mammogram.
"Only around one in 25 women will be called back for further assessment, but don’t panic if you require further testing – it doesn’t necessarily mean that you are facing a cancer diagnosis," Professor Kirwan says.
"You may be recalled if the image taken on your scan wasn’t clear enough, this should be mentioned in your recall letter, and would be referred to as a ‘technical recall’.
"It is more common to be recalled after your first mammogram, as there aren’t any mammograms to compare to."
How often do I need to have a mammogram?
The NHS Breast Screening Programme invites all women from the age of 50 to 70 for screening every three years.
This means that some people may not have their first screening mammogram until they are 52 or 53 years.
If you are older than 70, you can still have a screening every three years if you speak with your GP, but you won't automatically be invited.
The importance of being breast aware
NHS England are also keen to urge women of all ages to be aware of their breast health and to know how to check themselves for cancer symptoms.
Being ‘breast aware’ means getting to know how your breasts look and feel at different times and telling your doctor straight away if you notice any unusual changes.
It takes only a few minutes to perform and can help detect breast cancers at an earlier stage.
It is important that women continue to look at and check their breasts regularly, even if they have had a recent mammogram.
Anyone who has noticed any abnormal changes should contact their GP as soon as possible.
Women are encouraged to use the ‘TLC’ method for checking their breasts and can visit Breast Cancer Now for more information:
TOUCH your breasts. Can you feel anything new or unusual?
LOOK for changes. Does anything look different?
CHECK any new or unusual changes with your GP.
More information on NHS breast screening checks is available at www.nhs.uk/conditions/breast-screening-mammogram and you can find your local NHS breast screening service here.