Australian Government Department of Health
BreastScreen Australia Program
Photos of Women

Frequently asked questions

Answers to commonly asked questions about breast cancer and breast cancer screening.

1. What is BreastScreen Australia?
2. When did BreastScreen Australia begin?
3. How do I update my contact details?
4. What is breast cancer?
5. What causes breast cancer?
6. What are the main risk factors for breast cancer?
7. What are some of the unproven risk factors associated with breast cancer?
8. At what age does BreastScreen Australia encourage women to start having screening mammograms?
9. Why does BreastScreen Australia promote re-screening every two years for women aged 50-69 years?
10. What is the national BreastScreen Australia policy on screening women younger than 50?
11. What is mammography?
12. What is a digital mammography?
13. How is a screening mammogram taken?
14. How are my results decided?
15. What results might I get?
16. What are the differences between a screening mammogram and a diagnostic mammogram?
17. Does having a mammogram hurt?
18. Can a mammopad be used during a screening mammogram?
19. Are mammograms safe, what about the radiation?
20. Do mammograms cure cancer?
21. Should women with a disability have a mammogram?
22. Where can I go and how do I book to have a mammogram?
23. Can I have a mammogram if I have breast implants?
24. Do women who perform breast self examination still require a screening mammogram?
25. I have a family history of breast cancer. Should I have a mammogram even though I am under 40 years of age?
26. Is there any risk for my unborn child if I have a routine screening mammogram when pregnant?
27. Can I have a mammogram if I am breastfeeding?
28. Where can I find information on breast awareness?
29. Lately, I have noticed a change in one or both of my breasts. Is this cancer and what should I do?
30. Is thermography as effective as having a mammogram?
31. What is Magnetic Resonance Imaging (MRI)?
32. Are there any other effective ways of screening for breast cancer?
33. Where can I find information about the risk of breast cancer in women exposed to diethylstilbestrol (DES) in utero?
34. What is 'over-diagnosis' from mammography screening?

1. What is BreastScreen Australia?

BreastScreen Australia is the national breast cancer screening program. It provides free screening mammograms at two-yearly intervals for women aged 50-69 with the aim of reducing deaths from breast cancer in this target group, through early detection of the disease.

The state and territory governments have primary responsibility for the implementation of the program at their local level. The Australian Government provides overall coordination of policy formulation, national data collection, quality improvement, monitoring and evaluation.
Top of page

2. When did BreastScreen Australia begin?

Funding for the National Program for the Early Detection of Breast Cancer was announced in March 1990 and the program began in 1991. The name BreastScreen Australia was adopted by the program in 1996.

3. How do I update my contact details?

In order to update your contact details, please contact BreastScreen Australia on 13 20 50 for the cost of a local call.

4. What is breast cancer?

Breast cancer occurs when cells in a woman's breast tissue start to grow abnormally. Breast cancer can be benign (staying within the breast) or malignant (able to spread outside of the breast).

There are several different types of breast cancer. The term 'breast cancer' usually refers to the most common type, which is called adenocarcinoma. Other types of breast cancer include ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). Treatment for breast cancer depends on the stage and type of the disease, the severity of symptoms and the person’s general health (Cancer Australia).

Breast cancer is usually a slow growing cancer. Sometimes, breast cancer cells travel in the bloodstream or lymphatic system to other parts of the body such as the bones or liver. This is called metastatic breast cancer (or secondary or advanced breast cancer) - Cancer Australia.

Outcomes for women with breast cancer are improving over time. This is probably due to early detection through screening and more effective treatments. For data on survival rates, you can view the Australian Institute of Health and Welfare publication - Cancer in Australia 2010: an overview.

5. What causes breast cancer?

The cause of breast cancer is unknown.

6. What are the main risk factors for breast cancer?

Growing older

Age is the biggest risk factor in developing breast cancer. Around 75% of all breast cancers occur in women over the age of 50. Current research shows that breast cancer screening is most effective in detecting early breast cancer in women aged 50-69 years.

Family history

Family history can be a strong indicator of women who are likely to benefit from screening. Having a mother, sister, daughter, father, son, brother, aunt or cousins who developed breast cancer before the age of 50 increases a woman’s risk of developing breast cancer. Staff at BreastScreen Australia services can assist women in working out their family history.

However, nine out of ten women who develop breast cancer do not have a family history of breast cancer.

If you are concerned about your family history of breast cancer, you may wish to go to the Cancer Australia's website for more information.

Being overweight

Overweight women are at an increased risk of developing breast cancer, particularly after menopause. The level of risk increases with increasing body weight. (Cancer Australia)
Top of page

Alcohol

Having more than two standard drinks per day increases a woman’s risk of developing breast cancer. This risk increases with each additional 10g of alcohol intake per day. (Cancer Australia)

Hormone replacement therapy (HRT)

Use of combination hormone replacement therapy by postmenopausal women for five or more years is associated with increased risk of breast cancer. (Cancer Australia)

An individual woman’s level of risk in relation to HRT will vary according to her circumstances and medical history. Women who are considering starting or who are taking HRT should always discuss their risks and options with their doctor.

Oral contraceptive

Women who use oral contraceptive pill (the Pill) have a small increase risk of breast cancer while using combined oral contraceptives and in the 10 years after stopping.

Having a child late in age or not having any children

Women who have their first child at an early age have a lower risk of breast cancer. Women who never have any children or who have a child later in life have a slightly higher risk of developing the disease (Meister & Morgan 2000).

7. What are some of the unproven risk factors associated with breast cancer?

Smoking

Though smoking increases the risk of other cancers, it has not been shown to increase the risk of breast cancer. However, recent research raises the possibility that environmental tobacco smoke, or passive smoking, may increase the risk of breast cancer in some subgroups of women.

A bump or knock to the breast

There is no evidence that a bump or knock to the breast will increase a woman’s risk of developing breast cancer.

Stress

There is no evidence that psychosocial stress increases a woman’s risk of developing breast cancer

Wearing a bra

There is no evidence that wearing a bra will cause breast cancer. (American Cancer Society 2002)

Wearing deodorant

There is no evidence to support the view that wearing deodorant will increase the risk of breast cancer. (Meister & Morgan 2000)

Breast size

There is no evidence to suggest a link between the size of women's breasts and breast cancer. (Meister & Morgan 2000)

Top of page

8. At what age does BreastScreen Australia encourage women to start having screening mammograms?

BreastScreen Australia is targeted specifically at women without symptoms aged 50-69 years. Evidence shows that screening has the greatest potential to prevent mortality from breast cancer for this age group. Women aged 40-49 and 70 years and older, who have no breast cancer symptoms or signs, are also eligible for free screening mammograms.

9. Why does BreastScreen Australia promote re-screening every two years for women aged 50-69 years?

Two-yearly screening mammograms are the best way for women aged 50-69 years to detect breast cancer early, before there are any signs or symptoms. Early detection in this age group offers women a better chance of successful treatment and recovery.

10. What is the national BreastScreen Australia policy on screening women younger than 50?

Women 40-49 years

Age is the biggest risk factor in developing breast cancer. Around 75% of all breast cancers occur in women over the age of 50. Current research shows that breast cancer screening is most effective in detecting early breast cancer in women aged 50-69 years.

Current evidence indicates that the benefits of breast cancer screening for women aged 40-49 years are not strong enough to encourage all women in this age group to have regular breast cancer screening.

Women in their 40s who have no breast problems are able to have a free screening mammogram through BreastScreen Australia if they wish. However, they are not specifically targeted to attend.

BreastScreen Australia will continue to review this policy as new research becomes available.

Women 40 years and under

Regular screening mammograms are not recommended for women under 40 years. One reason is that the risk of breast cancer in young women is low compared to that of older women. Also, mammographic screening is not as effective in younger women. As women grow older and approach menopause, their breasts change and become less dense or solid. The tissue of younger women's breasts is usually more dense than that of older women and can show up as white areas on the x-ray. Breast cancers also show up as white areas on x-rays. This makes breast cancer more difficult to detect in young women. Women under 40 years of age are therefore more likely to have an unnecessary recall for assessment, with all the anxiety associated with this, and sometimes invasive investigations, when there was no cancer there in the first place.

Younger women who notice any unusual breast lumps, pain or nipple discharge should see their doctor immediately. Those who are concerned about their individual risk of developing breast cancer should also seek advice from their doctor.

11. What is mammography?

Mammography is usually referred to as the ‘mammography unit’ used by the radiographer to take the x-ray of the breast. A mammogram is an x-ray picture of the breast that is designed to detect breast cancer.

A screening mammogram can detect small lesions of cancer (as small as a pea or around 1cm). Detecting cancer at this early stage increases the effectiveness of treatments.

12. What is digital mammography?

Digital mammography is a technique that uses a computer, rather than x-ray film, to record x-ray images of the breast. The actual process of taking the mammogram still uses x-rays and the breast still needs to be pressed (compressed) to ensure a clear image of the breast tissue is obtained.
Top of page

13. How is a screening mammogram taken?

A radiographer will position and compress each breast in turn between two flat plates for about 10-15 seconds while the X-ray is being taken. For additional information on the screening mammogram process, please refer to “How do I arrange a mammogram?”

14. How are my results decided?

Your mammogram will be looked at by two or more health professionals specially trained in screening mammography. They are looking for any unusual areas of the breast which might be a sign of breast cancer. Based upon their decisions, you will be given one result – either ‘all clear’ or ‘recalled for further tests’.

15. What results might I get?

The vast majority of women will get an ‘all-clear’ screening result. This means that the mammogram does not show any signs of breast cancer. Women should still continue to know the look and feel of their breasts between screening mammograms, and report any changes that are unusual for them to their GP.

Sometimes women will be asked to come back to BreastScreen for more tests. This does not mean breast cancer is present, but sometimes more tests are needed to make sure. This happens more often for women having a mammogram for the first time. This is usually because there are no other mammograms to compare with. Something that may look unusual on your first mammogram may be completely normal for you.

Most women who are asked to come back for more tests do not have breast cancer. These tests are provided by BreastScreen Australia and are free of charge.

16. What are the differences between a screening mammogram and a diagnostic mammogram?

The key difference is the purpose for which the mammogram is done.

A screening mammogram performed in the BreastScreen Australia program is a free breast x-ray test for women who do not have any symptoms (i.e. asymptomatic or well women). Screening mammograms do not require a doctor's referral.

A diagnostic mammogram is a more complex x-ray of the breast and is done for the following reasons:
  • to evaluate abnormalities seen or suspected on a prior screening mammogram;
  • to evaluate abnormalities in the breast such as a lump, pain, thickening, nipple discharge or a inexplicable change in breast size or shape; or
  • in circumstances where it is difficult to obtain a clear x-ray by a screening mammogram, such as when a woman has breast implants.
A diagnostic mammogram may incur a cost and requires a doctor's referral to a private or public radiology practice. Diagnostic mammograms are not offered within the BreastScreen Australia program, except as part of further assessment following a screening mammogram that shows an abnormal area.

On occasions, it is necessary for women to be called back for additional x-rays, usually for technical reasons. Some women need to have additional tests at an assessment clinic because their x-rays show changes in their breasts. Such tests may include additional breast x-rays (diagnostic mammograms), an ultrasound and breast examination. Nine out of ten women who are asked to return for further tests do not have breast cancer.


17. Does having a mammogram hurt?

Pressing (compression) of the breast during a screening mammogram is vital to obtain the best possible picture and to minimise the amount of radiation that is used. If the breast is not compressed, the x-ray picture will appear blurred so that any changes which may have occurred will be harder to find.

Compression of the breast does not hurt for most women, although some women may find it uncomfortable or even painful. Occasionally the compression can result in breast tenderness or bruising but this does not last very long. If your breasts are generally tender, please let the radiographer know before your screening mammogram is taken. The compression will only last a few seconds and you can ask the radiographer to stop if necessary. There is no evidence that having a mammogram harms the breast.
Top of page

18. Can a mammopad be used during a screening mammogram?

A mammopad is a foam pad that rests between a woman’s breast and the plate of a mammography machine, this is also know as “comfort pad’.

BreastScreen Australia does not support the use of mammopad for screening mammography because it can affect the quality of the mammogram. Using a mammopad or similar device during the examination has the potential to increase the dose of radiation and reduce the quality of the mammogram.

To produce quality images, BreastScreen mammographers ensure every x-ray performed is to the highest possible standards. Any object that has the potential to reduce the optimal quality of the film, attenuate the x-ray beam, increase the exposure required to examine the breast, cause any skin folds or interfere with the image in any way, should be removed. High quality images optimise the ability to detect breast cancers at an early stage.

19. Are mammograms safe, what about the radiation?

Mammograms are safe as there is minimal exposure to radiation during a mammogram because modern mammography machines uses the smallest amount of radiation possible while still achieving a high quality x-ray.

20. Do mammograms cure cancer?

No. Screening mammograms do not cure cancer or prevent breast cancer from developing in the future, nor are they 100% accurate. However, in women aged 50-69 years, screening mammography is the best way of detecting unsuspected cancer at an early stage.


21. Should women with a disability have a mammogram?

Women with a disability are as much at risk of breast cancer as other women. BreastScreen Australia services endeavour to ensure that services are acceptable to and appropriate for women with disabilities.

In all states and territories women have access to a telephone helpline (13 20 50) for the cost of a local call. This provides further information on breast cancer screening, including access issues. Each woman’s individual requirements, including longer appointments and equipment needs, are recorded by BreastScreen Australia for their subsequent visits.

BreastScreen Australia’s National Accreditation Standards require services to meet the needs of women with a disability by:
offering longer appointments;
  • ensuring there is appropriate access to services;
  • ensuring all staff of the Service are adequately trained and equipped to provide care to people with a disability;
  • providing access to a nurse/counsellor;
  • facilitating transport, where appropriate; and
  • providing appropriate education materials.
For more information about access to BreastScreen Australia services ring 13 20 50 (for the cost of a local call). Alternatively, contact your state or territory BreastScreen Australia.

We recommend that you talk to staff about any particular requirements you may have when you make your booking.
Top of page

22. Where can I go and how do I book to have a mammogram?

In order to make an appointment for a mammogram, you can contact BreastScreen Australia by telephone on 13 20 50 (for the cost of a local call).

BreastScreen Australia services are provided in a wide range of centres, including mobile units (vans) in some areas.

23. Can I have a mammogram if I have breast implants?

Mammographic screening is generally safe for women with implants. There is an extremely small chance that the pressure placed on the implant by the mammography machine could cause the implants to rupture or break.

In women who have implants which have already ruptured or started to leak, it is possible that having a mammogram could increase the amount of silicone or saline (depending on the type of implant) spreading into the breast tissue.

In some women with implants, very small amounts of silicone or saline (depending on the implant) pass through the pores of the implant shell. This is sometimes called 'bleeding' of the implant. At present it is not known whether mammography increases 'bleeding' of implants.

There is a small chance that mammography will change the shape of the breasts by dispersing the fibrous capsule that often grows around the implant. The breast may feel softer after mammography. However, it cannot be guaranteed that both breasts will be affected equally.

You should discuss with your doctor as to whether screening mammography is suited to your particular circumstances. Should you decide to attend for a screening mammogram, please advise the staff when you make the appointment that you have implants.

For further information, please see Management of women with breast implants.

24. Do women who perform breast self examination still require a screening mammogram?

Yes. Breast self examination does not replace the need for a screening mammogram. Breast awareness is an important part of health care. It helps you to learn how your breasts feel normally, so that if you notice any changes or lumps in your breast to consult your doctor as soon as possible.

A screening mammogram can detect small lesions of cancer (as small as a pea or around 1 cm) whereas the size of a cancer detected by physical examination is larger (around 2.5cm in diameter).

Women who perform breast self examination and who are eligible for the BreastScreen Australia program should start/continue to have two-yearly screening mammograms.

25. I have a family history of breast cancer. Should I have a mammogram even though I am under 40 years of age?

While having a family history of breast cancer can increase your risk, it is important to note that nine out of ten women who develop breast cancer do not have a family history of breast cancer.

Cancer Australia has an online risk calculator intended to help you work out if you have an increased chance of developing this disease.

See your doctor to discuss any further concerns regarding your family history of breast cancer. If you require a further examination your general practitioner will refer you to a specialist.

26. Is there any risk for my unborn child if I have a routine screening mammogram when pregnant?

No, a routine screening mammogram when pregnant does not affect the unborn child. The kilovoltage of the X-ray used during a screening mammogram is very low which does not have sufficient penetrating power to provide a dose to the unborn child.

However, it is advised that women wait until after their pregnancy before undergoing a screening mammogram. This is because breast tissue is more dense during pregnancy (and breastfeeding), which significantly reduces the sensitivity of mammography.

If a diagnostic mammogram is required during a pregnancy it is not recommended that a women delays her mammogram. Further information and advice on this issue should be sought from a woman’s general practitioner or specialist.

For additional information on difference between a screening and diagnostic mammogram, please see FAQ.

Reference:
National Breast Cancer Centre1 2002: Breast imaging: a guide for practice
Top of page

27. Can I have a mammogram if I am breastfeeding?

You should generally wait six months after you have stopped breastfeeding to have a mammogram, as the image can be harder to read and you may also experience increased discomfort. If you think you have any symptoms of breast cancer you should see your doctor who may refer you for diagnostic procedures.

28. Where can I find information on breast awareness?

The Cancer Australia's website has information for women on breast health. This material appears in a section targeting women under 40 years of age as mammograms are not recommended for women in this age group. The techniques described are suitable for women over 40 as well.

29. Lately, I have noticed a change in one or both of my breasts. Is this cancer and what should I do?

From time to time you may find breast changes, such as:
a lump or lumpiness;
  • any change in the shape or appearance of the breast such as dimpling or redness;
  • an area that feels different to the rest;
  • a discharge from the nipple;
  • any change in the shape or appearance of the nipple such as pulling in or scaliness (nipple inversion or retraction); or
  • pain.
Many women are concerned that a breast change might be breast cancer. Even though this will not be true in most cases, it is very important that all breast changes are carefully investigated. If it is cancer, finding it early will mean a much better chance of effective treatment.

If you notice a breast change or experience a breast symptom you should see your doctor without delay. A doctor will do a clinical breast examination and refer you for further tests such as a diagnostic mammogram or ultrasound if needed. These tests require a doctor's referral and may be performed in a private radiology practice or a public hospital.

30. Is thermography as effective as having a mammogram?

BreastScreen Australia does not recommend the use of thermography for the early detection of breast cancer.

Studies have shown that a tumour has to be large (several centimetres in diameter) before it can be detected by thermography (Homer 1985). In 2009, a detailed review was undertaken of technology for breast cancer detection as part of the BreastScreen Australia Evaluation. For a copy of the report, please see National Horizon Scanning Unit Emerging Technology Bulletin. Screening mammograms have the ability to detect breast cancer at a much smaller size, and therefore to reduce deaths from breast cancer. Less than 50% of breast cancers detected by mammography screening have an abnormal thermogram (Martin 1983).

There currently is no scientific evidence to support the use of thermography in the early detection of breast cancer and in the reduction of mortality. For further information, please see Statement on use of thermography to detect breast cancer.

31. What is Magnetic Resonance Imaging (MRI)?

Magnetic Resonance Imaging (MRI) makes use of strong magnetic fields and radiofrequency pulses to generate sectional images of the body in any plane and is especially useful in examinations of soft tissue.

It is an important tool for working with diseases such as cancer. Unlike other imaging modalities (X-ray and CT scans), MRI does not use ionising radiation. MRI of the breast is not available at BreastScreen Australia, but is available through public, private hospitals as well as private diagnostic imaging providers in a large number of locations around Australia.

Since 1 February 2009, the Australian Government has been funding Medicare rebates for annual MRI breast scans for women. To be eligible for the rebate you must be a female who is less than 50 years of age, with no current signs or symptoms of breast cancer, who has been identified as at high risk of breast cancer due to family history or genetic mutation. In addition, for an MRI scan to attract a Medicare rebate, the scan must be requested by a specialist medical practitioner or consultant physician and be performed on a Medicare-eligible MRI unit. Please refer to the Medicare Benefits Schedule for additional information.

For further information, please see Breast Magnetic Resonance Imaging questions and answers.
Top of page

32. Are there any other effective ways of screening for breast cancer?

In 2009, a detailed review was undertaken of technology for breast cancer detection as part of the BreastScreen Australia Evaluation. This review found that mammography is the only acceptable screening tool. This is also supported by the International Agency for Research into Cancer, which has examined all the available evidence and determined that mammography is the best early detection method available for detecting breast cancer at its earliest stages among women over 50 years of age.

The BreastScreen Australia Evaluation Final Report highlighted a fall of 25% in mortality since the introduction of mammography screening.

33. Where can I find information about the risk of breast cancer in women exposed to diethylstilbestrol (DES) in utero?

For information on the risk of breast cancer in women exposed to DES in utero, please refer to the
Cancer Australia's Position Statement.

34. What is 'over-diagnosis' from mammography screening?

For information on 'over-diagnosis' from mammography screening, please refer to the
Cancer Australia's Position Statement.

1 In February 2008, National Breast Cancer Centre (NBCC), incorporating the Ovarian Cancer Program, changed its name to National Breast and Ovarian Cancer Centre (NBOCC). In July 2011, NBOCC amalgamated with Cancer Australia to form a single national agency, Cancer Australia, to provide leadership in cancer control and improve outcomes for Australians affected by cancer.

Page currency, Latest update: 12 December, 2013