Overview

**Please note, the following information is directed at health care professionals. If you require general information about the Northern Ireland Cancer Screening programme, please click here**

COVID-19 impact on the Breast Cancer Screening Programme

Routine breast cancer screening was temporarily paused for four months in 2020 in response to the COVID-19 pandemic.  In addition, the number of women the programme can currently screen in each screening clinic is reduced due to the need for appropriate infection prevention and control measures.  This has led to a backlog of women awaiting screening but the programme is working to address this issue.  Further information about COVID-19 can be found here.

You can also find some frequently asked questions about attending for breast screening during the pandemic in the Public Health Agency’s website by clicking here

The Surveillance Screening Programme for Women at Very High Risk of Breast Cancer (VHR Programme) was not paused and has continued to run as normal.

You can find further information at our  Very High Risk Programme  section.

The Breast Screening Programme

The Breast Screening Programme covers the whole of Northern Ireland. It is provided by four Breast Screening Units which, between them, normally invite over 82,000 women a year.

 

Who is eligible for breast screening?

Women aged 50–70 are invited for breast screening, by GP practice, every 3 years. As the women in each GP practice are invited every 3 years, on average about a third of women will be invited for the first time before their 51st birthday (in the year they turn 50), a third before their 52nd birthday (in the year they turn 51) and the rest before their 53 birthday (in the year they turn 52).   All eligible women should be invited for the first time before their 53rd birthday.  As the women who are invited before their 51st birthday are invited in the year they turn 50, some women will be invited for breast screening for the first time when they are 49.

Women invited for the first time in the year they turn 50 are invited for the last time in the year they turn 68.  Women invited for the first time in the year they turn 51 are invited for the last time in the year they turn 69, and women invited for the first time in the year they turn 52 are invited for the last time in the year they turn 70.  Everyone receives a total of 7 invitations.

Although women over the age of 70 are not routinely invited for breast screening, they are encouraged to call their local breast screening unit to request screening every three years. Cards are produced by the Public Health Agency to help women over 70 remember to do this. These are handed out at their last routine breast screening appointment. For further information read our leaflet  Over 70 – what now? Looking after your breasts.

 

How are women called for screening?

All eligible women who are registered with a GP practice will automatically receive an invitation. There is no need for them to contact anyone, but it is important that the GP has the correct date of birth and contact details recorded on NHAIS (the IT system that underpins primary care). NHAIS is the source of the demographic data the Breast Screening Programme uses to identify women for call and re-call for breast screening.

 

What is the process?

Outside of the Belfast Trust area, most breast screening is provided on mobile breast screening units. These visit a number of different sites throughout Northern Ireland. Click here to see where screening is currently taking place.  In Belfast women are invited to attend the breast screening unit at Linenhall Street.

A visit to a breast screening unit usually takes less than 30 minutes and the mammogram only take a few minutes.  More information on the screening process can be found here

 

What are the harms and benefits?

The main benefit of the breast screening programme is the reduction in mortality from breast cancer. Screening saves about 1 life from breast cancer for every 200 women who are screened. This adds up to about 1,300 lives saved from breast cancer each year in the UK.

The cancers detected in screened women are smaller and are less likely to be treated by total mastectomy, or to require chemotherapy.

One of the harms of breast screening is overdiagnosis and overtreatment – About 3 in every 200 women screened every 3 years from the age of 50 to 70 are diagnosed with a cancer that would never have been found without screening and would never have become life-threatening. This adds up to about 4,000 women each year in the UK who are offered treatment they did not need.

For more information on the benefits and harms of screening see the leaflet Helping You Decide.

 

Screening results

Results will normally be sent to the woman within 2-3 weeks of her attendance at the Breast Screening Unit.  Her GP will also get a copy.

There are 3 possible results:

Normal/ routine recall

If the result is normal the woman will be automatically invited for screening in 3 years’ time, unless she will be over the age of 70, in which case she can contact the screening office for an appointment.

Technical recall

This means the mammogram needs to be repeated for technical reasons only.

Assessment

Around 4 in every 100 women screened are called back for a second visit. This is because the result suggests that further tests are needed. This does not necessarily mean there is something wrong – 3 out of 4 women recalled for assessment are given normal results following these additional tests. For further information read our leaflet  Breast screening: why have I been called back?

 

Self-examination between appointments

Breast cancer can develop between visits so it’s important for women to check their breasts regularly for changes.  They should become familiar with how their breasts normally look and feel to detect changes. For further information on how to be breast aware click here.

 

Women with breast symptoms

A woman presenting to her GP with symptoms should not be referred for breast screening, but should be referred to hospital for an outpatient appointment at the symptomatic breast clinic.

 

Interval Cancers

Screening helps detect breast cancer early, but it is not perfect. Of 1,000 women screened for breast cancer who have a normal result, around three will develop breast cancer before their next three-yearly screening appointment. These are known as interval cancers.  Interval cancers are an inevitable part of the breast screening programme.  For further information read our leaflet Information for women diagnosed with breast cancer between screening appointments or go to our interval cancer page by clicking the following link Programme Guidance | Cancer Screening Northern Ireland (hscni.net)

 

Screening process if you have breast implants

Women with breast implants should contact their local unit on the number given in the appointment letter so that extra time can be given for their mammograms. It’s important for women to tell the mammographer if they have implants before they are screened. For further information read our leaflet Breast Screening and breast implants.

 

Transgender

Transgender men and non-binary people assigned female at birth:

  • Transgender men and non-binary people assigned female at birth who are registered with a GP as female are automatically invited for breast screening if they are within the eligible age range (50-70) and can self-refer over the age of 70.
  • Transgender men and non-binary people assigned female at birth who are registered with a GP as male are not invited for breast screening, but can request referral for mammography through their GP.

Transgender women and non-binary people assigned male at birth:

  • Transgender women and non-binary people assigned male at birth who are registered with a GP as female are automatically invited for breast screening if they are within the eligible age range (50-70) and can self-refer over the age of 70.
  • Transgender women and non-binary people assigned male at birth who are registered with a GP as male are not invited for breast screening, but can request referral for mammography through their GP.

Individuals can contact the breast screening unit and ask not to be invited for breast screening i.e. to be ceased from the programme.  People who have had a total bilateral mastectomy and no longer have breast tissue do not require breast screening.

 

Support Available for those who need it at their Breast Screening Appointment

Information for those who require extra support when attending for breast screening can be found here  eg women with a disability, sensory impairment, translator requirement.

 

Learning Disabilities

A video for women with learning disabilities can be found by clicking here

The charity Beyond Words has published a wordless picture story, ‘An Easy Guide to Breast Screening’. Click here  to view a copy.

 

When should a woman be ceased from breast screening?

The only circumstances under which a woman should be ceased from breast screening call and recall are:

  • if the woman has had a bilateral mastectomy
  • if the woman has made her own informed decision that she no longer wishes to be invited for breast screening
  • if the woman lacks the mental capacity to consent to screening and a decision has been made appropriately that it is in her best interests to remove her from the screening list

In all other circumstances, the woman should be kept in the recall programme and sent another invitation for screening (assuming she is still eligible) so that she has the opportunity to make an informed decision about whether to accept on each and every occasion when screening is offered.

 

Screening Now Taking Place

Screening takes place at the static units or at one of the mobile units located within each Trust area. The mobile units move around their area staying at each site for a few months, contact details for each of the Trust areas are given below.

For current dates and locations of screening clinics please click on the relevant Trust link below.

Belfast and South Eastern Trust   see screening timetable
Northern Trust  see screening timetable
Southern Trust  see monthly screening
Western Trust  see mobile screening unit

      

 

   

 

 

Further information about breast screening can be found in our FAQ’s section by clicking here.

Or by contacting the Northern Ireland Breast Screening programme, using the contact information below:

Public Health Agency

Young Person and Adult Screening Team

9th Floor, Linum Chambers

2 Bedford Square

Bedford Street

Belfast

Tel: 0300 555 0114     EmailScreening.breast@hscni.net