03.Breast cancer screening
The successful BreastScreen Australia program operates in more than 500 locations, using X-Ray mammography.
It’s aimed at women without symptoms aged 50 to 69, but women aged 40 and older can get free screening. It is one of the most comprehensive population-based screening programs in the world – well over 1.5 million women were screened in 2005/2006. Generally, mammography is less effective in younger women because of dense breast tissue being more opaque to X-rays. Older women (aged 70+) who have been involved in the program can elect to continue free two-yearly screening.
Despite actively recruiting women in the 50-69 year age group, only 57% of them are screened. This is disappointing, given the program’s objective is to screen 70% of this group. About 25% of screens are in women outside this age range. Breast compression during mammography may discourage some women, but early detection and a better chance of successful treatment can only happen if you are screened.
Effectiveness of screening
Regular two-yearly mammograms have been shown to pick up many small tumours in the early stages of development before they start to spread to other parts of the body. Most of these can be successfully treated.
A recent report says that between 1991-2006, BreastScreen Australia reduced breast cancer mortality in women aged between 50-60 by up to 29%. A rigorous accreditation process applies to all sites to ensure maintenance of the highest possible standards.
Research is ongoing to find ways to improve the false negatives and false positives of screening tests. Technologies other than X-Ray mammography, such as ultrasound and magnetic resonance imaging (MRI), are showing some promise, but so far only in conjunction with mammography.
Genetic screening can also be useful where there is a family history of breast cancer, but it can be expensive (see Genetic Testing Explained, left ) and raises quite difficult ethical issues, such as life insurance companies reducing their risk exposure and other family members not wanting to know their high-risk status. A useful reference is ‘Advice about familial aspects of breast cancer and epithelial ovarian cancer’, which can be found at www.nbocc.org.au (search for ‘familial aspects’).
Cancer Council Australia
Cancer Helpline 13 11 20 (cost of a local call)