Breast screening
How to read the stories

Breast screening

Breast screening is a method of detecting breast cancer at an early stage, often before a woman has any obvious symptoms. The aim is to offer more effective treatment and to reduce deaths from the disease.

All women aged between 50 and 70 years who are registered with a general practitioner (GP) are invited for breast screening every three years. Arrangements are in progress to extend routine invitations to women aged 47–73. Older women are entitled to screening every three years at their own request.

Breast screening is a two-stage process. The first stage is a breast x-ray (mammogram). Most women have a normal result, but some are recalled for further tests (assessment).

The further tests take place in an assessment clinic and may include another mammogram, clinical examination of the breast, ultrasound or biopsy. Only between 3% and 7% of women who are recalled for assessment are diagnosed with breast cancer.

Breast awareness

Breast awareness is the process of getting to know what is normal as part of general body awareness. The aim of breast awareness is to encourage women to become familiar with their normal breast tissue at different times of the month. All women, especially those over the age of 40, should be breast aware because:

early detection is the single most important factor in improving survival from breast cancer
the majority of breast cancers which can be felt are found by women themselves or by their partners
it is better to start breast awareness early, to establish what is normal
women between the ages of 50 and 70 years who attend for routine breast screening should continue to be breast aware between mammograms
the risk of developing breast cancer continues to rise with age so women who are 70 and over should continue to be breast aware.

The breast awareness five-point code is:

know what is normal for you
look at and feel your own breasts
know what changes to look and feel for
report any changes without delay
attend for routine screening if aged 50 or over.

Women with learning disabilities should be encouraged to get to know their own bodies so that they can notice changes too. This should involve being aware of all parts of the body, especially those normally covered by clothes. Bathing and drying is a good time to do this. Feeling and looking in a mirror are good ways of noticing changes. If a woman is not able to do this for herself, then a female supporter who provides personal care should do a visual check for changes.

What to look for

changes in shape, size, symmetry
puckering, dimpling or ‘orange peel’ appearance of the skin
veins which stand out more than normal
rashes
discharge from the nipple
change in position of the nipple (pulled in or pointing in a different direction)
look for anything that is new for the woman.

Some women with learning disabilities may not act on signs which are very obvious, and supporters and carers need to be aware of an unusual smell or a weeping and sticky sore on the breast.

How to read the stories

There is no right or wrong way to read the stories.

Some people are not used to reading stories. Start at the beginning and read the story in each picture. Encourage the reader to move through the pages at their own pace.
Encourage the person to tell the story in their own words. You will discover what they think is happening, what they already know, and how they feel. If you are using the pictures to help explain a procedure to someone, you may need to describe or clarify the actions being shown in each picture to help them understand. Try not to challenge the reader(s) or suggest their ideas are wrong.
Some pictures may be more difficult to understand. It can help to prompt the people you are supporting, for example:
• Who do you think that is?
• What is happening?
• How is he or she feeling?
• Do you feel like that? Has it happened to you/ your friend/ your family?
Allow people enough time to follow the pictures at their own pace. Allow time for discussion of each picture.
Some people may benefit from reading the larger story from which the extract has been taken. This will allow them to explore their feelings and experiences in more depth. To buy the complete book, follow the link to the bookshop that appears at the end of the story.