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Scenario

Sarah is at the counter talking to pharmacy technician Vicky.

“Did you hear about the mistake they made with the breast cancer screening?” says Sarah.

“I did hear about that, yes,” replies Vicky. “But you’re up to date with your check-ups, aren’t you?”

“Well, I think so, but I can’t remember how long it’s been since the last one, and when I phoned the GP surgery to ask to book a mammogram, I was told I couldn’t until I’m 70!” exclaims Sarah. “Honestly, just how ridiculous is that? I’m only 63, are they really expecting me to wait and come back in seven years?”

“I don’t think that’s quite what they mean,” says Vicky, cautiously.

“Well, explain it to me then please,” says Sarah. “I’m not sure I want to rely on them writing to me every time I’m due a scan – this fiasco shows how that system can break down.”

Answer

Breast screening hit the headlines recently when health secretary Jeremy Hunt announced a review into why nearly half a million women in England between 2009 and 2018 had failed to receive invitations for mammograms. What happened was effectively a computer glitch: women were called for screening up until their 70th birthday rather than their 71st, as should be the case. The issue came to light because Public Health England was analysing data from a trial investigating whether it was worth expanding the national programme to women as young as 47 and as old as 73 years.

In the UK, women registered with a GP are automatically invited for breast screening every three years from the age of 50 years up until their 71st birthday. After this, women are allowed to request appointments every three years.

Sarah’s GP surgery should be able to tell her when her last mammogram was and when she is likely to be next called. All women affected by the computer glitch should have, by the end of last month, received a letter inviting them for a catch-up screen. These will be conducted at local clinics following coordination by a national helpline that has been set up.

The bigger picture

Around two and a half million women are invited every year for testing as part of the NHS initiative, with around two million taking up the offer, and current evidence suggests that it reduces the number of deaths from breast cancer by around 1,300 a year. According to Cancer Research UK, this is because it increases the chance of detecting cancers at an earlier stage when they are easier to treat and more likely to be cured. But there is a flipside to this.

A Danish study published last year highlighted the limitations of breast screening, stating that it could lead to treatment of tumours that may never have caused any issues while not preventing more dangerous and advanced cancers. Clearly, balance is required as Breast Cancer Care’s clinical director Emma Pennery comments: “It’s estimated that for every life saved through screening, three women will have unnecessary, often diffi cult, treatment. However, despite its flaws, screening remains the most effective tool at our disposal for detecting breast cancer at the earliest possible stage.”

Extend your learning

• Would you be able to explain what happens to a customer what happens during a mammogram? Check your knowledge 
• Do you know the location of your local breast screening service? Find out here
• Are you confident to explain how to  check your breasts, and what the signs of breast cancer can be?
• Screening doesn't lead straight to a diagnosis; other tests are performed. Read about these here.