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Mammography Screening for under 50's
Routine mammography screening is not available on the NHS for women under the age of 50, but private mammography screening is available. Women who decide they want to pay for their own mammography screening may come up against a number of unexpected hurdles. |  |
Breast cancer is the most common cancer in England and Wales, resulting in the highest cancer death rate in women. One in nine women will develop breast cancer during their life, with four out of five cases being in women over the age of 50. The peak age is 50 – 54 years, which is due to the fact that many women have under gone their first mammography screening during this period.
Routine mammography screening is offered to all women between the ages of 50 and 70 on the NHS, every three years. Women over 70 can have mammography screening upon request. For women under the age of 50, routine screening is much less clear There is much debate as to whether screening is valuable in the under 50’s, however the issue remains important to both policy makers and the individual. With one in five breast cancers occurring in women under the age of 50, the death rate among this group amounts to one third of all those who die from this disease. A 63% reduction in breast cancer mortality rate was found among women aged 40 – 49 who were screened. Women who underwent mammography screening over the age of 40, were also found to have smaller tumours. This resulted in the majority of these women being able to conserve the breast as opposed to having to have a mastectomy, thus giving the patient a wider choice of treatment options.
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| Most of the known risk factors relate to a woman’s reproductive history such as early age for commencing the menstrual cycle and late age for cessation of it. Late age for a first pregnancy and having no children are also risk factors. Medication such as the oral contraceptive and hormone replacement therapy, along with obesity and increased alcohol consumption increase the risk too. Many specialists recommend screening high risk women under 50 at least annually and possibly those under the age of 35 years. Genetic syndromes are responsible for a small but significant percentage of breast cancers, however the vast majority of cancers occur in women with no family history. |
In the USA most major medical organisations advise screening mammography for women from the age of 40. The American Cancer Society, the American Medical Association and the American College of Radiology back this advice. Other countries such as Australia, Israel, Japan, Sweden, Spain, Belgium, and France are also finding that woman under 50 show significant benefits to having mammography screening.
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| Despite evidence coming out of the UK the recommendations are still for NHS screening after the age of 50. Women need to be informed and allowed to make their own choices about their health, if they are financially able to pay for it. Some women may be covered under insurance policies that may offer health prevention, as well as cover for illness. However it is not as simple as making a telephone call to book an appointment. For women under 40, it can prove to be a very difficult task, however over this age it is not so difficult, if you understand the local procedures. |  |
The first thing to do is find out where you can obtain a private mammogram locally. There may be a local private hospital or a chain of hospitals such as BUPA that offer this facility. Equally the local NHS hospital may offer private mammography. Each facility will have their own individual policies, determining whether a patient needs to be examined by a doctor prior to mammography. The cost of mammography will vary between facilities but you can expect this to be in the region of £100 - £150.
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Before thinking about the option of private mammography it is essential to determine whether you are experiencing any breast changes or symptoms. If there are any problems the General Practitioner should be consulted. Referral to a breast specialist on the NHS may be appropriate. |
It is important to know that false positive readings can occur which will require additional investigations to determine whether breast cancer is present. Obviously anxiety occurs if this does happen, and many women find that they are anxious by the thought of the being screened for breast cancer.
The mammography screening requires you to remove your bra so that your breasts can be squeezed by an x-ray machine, which can be slightly uncomfortable. It is essential that you do not wear deodorant as it can show up on the x-ray. Sometimes x-rays need to be repeated, which does not necessarily indicate a tumour, but may be required for technical reasons. Usually when you are paying privately for mammography, most facilities give the results immediately after the procedure is done. If this is not done, then you will be informed about how you will be told of the results. A copy of the report will be sent to your General Practitioner.
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If you decide to have a private mammography you will need to get a referral from your General Practitioner. For women under the age of 40, some hospitals will refuse to allow a private mammography to take place. If there are high risk factors then the General Practitioner can make a NHS referral. |  |
Routine mammography screening between 40 – 49 years, significantly reduces the mortality rate in the 20% of breast cancer sufferers who are below 50yrs at the onset of their cancer. Whilst the NHS is not offering this routine screening to this age group of women, there is strong evidence from around the world that women would benefit.
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Mammography screening and the early detection of breast cancer saves individual lives. Families and children will be forever grateful that a breast cancer sufferer simply did not die because she fell into the wrong age group. For women below the age of 40 the picture remains less clear. |
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