If you are over 50 and an HCP or related, did you take up the offer of breast cancer screening?

[Sadik]

I have to say I'm very impressed with the leaflet laying out the pros and cons.

But as a result of their even-handedness and honesty I'm now dithering over what the best thing is to do! Interested to know what choice those with more scientific knowledge than me made.

Not an HCP... but I do science. Epidemiology. And evidence evaluation.
I decided not to get screening. I have colleagues who decided not to. Mind, I got a mammogram last yr for a mystery lump, so all up to date after all :) .

There's some kind of blow up going on in Cochrane, including with the prominent reviewer who questioned the safety & efficacy of the screening. So I would downplay now his findings. At least, I don't know how to consider them.

My own specific reasons is that A) I can live with the consequences, I'm not a "zero risk" person B) I am low risk in many of the risk factors (most women are high risk in most of them) C) screening is not risk-free itself; D) screening on avg finds a lump at half the size found manually, but the avg one found manually is still found at a very early stage; E) screening makes up for lack of self-examination, if your breasts are small, mammograms once every 3 years don't offer a big risk reduction on monthly self-exam; F) I can live with the consequences, I'm not a person who believes in "safety first."

The most important RF for me is age, so I had planned to start getting screening at some point in my 50s, anyway, just not right at 50. Maybe 56 or 57? Did I mention points A) & F)?

If active HCP yourself I imagine you may struggle to even get the time off (shame). Good luck in your decisions. It's all about patient autonomy, isn't it? :)

absolutely, as soon as I can have the screening, I will.
I know personally of three people who had breast cancer picked up from the screen they had when they turned 50.
I can't think of many good reasons not to have the test.

lottiebel the reason not to have the test would be the false positives - that's not quite the right word - but the 3 in 200 women who are treated un-necessarily as the result of screening.

Compared to 1 in 200 women having lifesaving treatment, it's a significant factor in choice.

I have very small breasts Medschoolrat and do self-exam religiously, so I think I may put off at least until further into my 50s. I'll check out the other risk factors further though - that's a good point.

Retired HCP. I’ve gone for the screening a couple of times, basically ever second invitation, and will go one more time before reaching seventh (if I don’t get run over by a bus before then )
But, I do self-check, and have zero female relatives who have had any breast or gynae cancers (and I have a big family). So, whilst a bit of a fence sitter re the pros and cons, I think i’ve made a reasonable informed decision.

*every other invitation
*seventy not seventh

Not a HCP but can't understand why anyone wouldn't. My friends lovely mum had a lump picked up on her first mammogram. She has just had the all clear after having the lump removed and radiotherapy.

Sorry, I should say I'm not an HCP - I just thought that I'd get more useful and informed perspectives. I can tell you lots about risk etc as it relates to plants! If I were only a cabbage, I could make a wonderfully well informed decision.

"Not a HCP but can't understand why anyone wouldn't."
Because of the risk of undergoing life changing but un-necessary treatment. As I say, the patient information leaflet is excellent and clear, and makes it very evident that there are reasons to make either choice. (I do for example go for cervical screening religiously, as I understand it the benefits there are clear and unambiguous.)

I'm not an HCP. I have a bad family history on my mum's side - she's never had cancer but her sister, mother, father, two of her mother's sister and one of her mother's brothers all died of cancer and in the case of the women it was all breast cancer (post-menopausal). I started getting screening on the NHS when I was 40 (as did she). No problems so far, thank goodness, but I am overweight, which is another risk factor. On balance I think it's the right thing for me. I can live with the risk of a false positive.

Having got an elevated risk of breast cancer I was happy to have my first one days after I turned 40.

Benefits outweigh the risks for me.

I have absolutely no risk factors and chose not to until this year. I am 62. Probably won't go again as have zero family history. Obviously if I had I would think differently.

Do you know whether - if you turn down screening in the short term - you remain on the list and are invited back for future years?

I'm actually only 49 atm (it's a mobile screening unit and I suspect only comes out this way occasionally) so I'm very tempted to wait until I'm a bit older at least.

They will offer again. I was offered first at 46 or 47 (I declined... I thought 47 was being rolled out nationally in England, from 2018 onwards). They offered again at 50.

Most of the time I do believe most of us should just do what the expert consensus says. I don't question what kind of fuel to put in my car or which updates to do on my laptop or the advice not to stick my fingers in the electrical sockets. DH has history of cancers in his family (including breast & ovarian) & DD is unlikely to have healthy lifestyle, so I could see me wanting DD to get regular screening by mid 40s to 50yo.

I haven't seen the leaflet. The 3/200 stat might include unnecessary investigations (biopsies) as well as actual treatment, so the unnecessary treatment group could be fewer than 3/200.

My friend and I were called two years early as the area we were in had a trial and invited all women age 48 and 49. My friend had no lumps as such but she had a very aggressive strain of breast cancer. She is by trade a biochemist, that mammogram saved her life.

I agree, generally I do absolutely go with the expert consensus on such things. I guess in this instance my problem is the leaflet as written (I'm in Wales, so maybe different to the English one) is very much 'you may want this, but you may not, there are good reasons for either choice'.

I'll investigate the 3 in 200 figure further, but it does look to be un-necessary treatment rather than simply investigations.

My mums breast tumor was found at a mammogram. It was big and attached to her chest wall and had begun to spread to her lymph nodes. She had no symptoms and nothing showed in blood tests.

Due to its position she would never have found it through self examination. She was treated by one of the top surgeons and his team. None of them could feel it when they examined her.

In all likelihood without the screening programme she would never have known until it had spread to other organs.

That mammogram saved her life.

Yes you do get invited back, and invited back, and invited back.... you can just ring up and cancel the appointment.

No HCP here, but:

Me and my DM both had false negatives - my mother believed the results - I didn't.

I don’t work in health care so I can’t answer your question from a point of view of scientific knowledge. But I am being treated for breast cancer so can answer from personal experience.
I’ve reread the leaflet and I can see why it might make you dither. I’m fairly sure the 3 in 200 it refers to are women diagnosed with DCIS.
I have bilateral breast cancer. On one side I had an invasive cancer and on the other I had DCIS and it was suspected I also had an invasive cancer hidden in the DCIS. This was found to be the case after my lumpectomy.
I think I’m right in saying that the 3 in 200 that the leaflet have DCIS but because this can become invasive if left untreated that statistic is maybe not all it seems.
For those who have said they are happy not to be screened because they don’t have any family history. The genetic risk is a very small percentage. I think under 10%.
There are of course risk factors. Genetics, being overweight, smoking, HRT, contraceptive pill, excess alcohol consumption. Or as my oncologist said just bad luck.
I can see why reading the leaflet can make you doubt but as one of the 1 in 200 with invasive cancer I’m glad I had the screening.
Oh and also just worth pointing out that finding a lump by checking for yourself is not really about the size of your breasts but about the location of the lump.