Introduction to breast cancer and breast screening
About breast cancer
- Breast cancer is a collection of cells in the breast tissue that grow in an uncontrolled way.
- Breast cancer is the most common cancer affecting women in NSW, with 1 in 8 women developing breast cancer in their lifetime.24 While much less common, men can also develop breast cancer.
- More than 75% of women diagnosed with breast cancer are over the age of 50.26
- In 2019 alone, it is expected 6,121 people will be diagnosed with breast cancer, and the disease will cause 974 deaths.
- 9 out of 10 women diagnosed with breast cancer do not have a family history of the disease.
- Finding breast cancer early improves survival. A mammogram is the best method to detect breast cancer early for women over the age of 50.26
About BreastScreen NSW
- BreastScreen NSW is a population-based screening program, funded by the Commonwealth and state government.
- Managed by the Cancer Institute NSW, the program is delivered by nine screening and assessment services, which are located and managed within local health districts.
- BreastScreen NSW is a free service delivered at more than 200 screening locations across NSW.
- The service invites women aged 50–74 years to screen every two years. However, the program is available to asymptomatic women from 40, and those aged over 74 years.
- Around 300,000 women are screened every year as part of the BreastScreen NSW program.
The role of general practice
While a doctor’s referral isn’t required for a BreastScreen appointment, research shows that, as a GP, you have a significant influence on your patient’s decision to screen. In fact, women are more likely to have a mammogram if they are advised by their GP than by anyone else.28
If your patient provides us with your details as her primary health care provider, BreastScreen will keep you informed throughout her screening and assessment process.
The need to improve breast cancer screening participation
- Nearly half of eligible NSW women are overdue for a screening mammogram.27
- Participation rates are lower for women from Aboriginal and culturally and linguistically diverse communities.
- Mammograms can find very small cancers (the size of a grain of rice) before they can be felt or noticed by an individual or a doctor. Early detection leads to better treatment outcomes.
- Women whose breast cancer is detected by BreastScreen NSW are half as likely to need a mastectomy.
- There are 10 areas across NSW where women experience higher rates of breast cancer risk factors. Despite this, more than 70,000 women in these areas have not had a mammogram in the past two years. These areas cross geographic and socioeconomic boundaries.
- Breast cancer risk factors include family history, physical inactivity, alcohol consumption and smoking.
Biennial breast screening participation rate for women aged 50–74, by primary health network (PHN) (ranked), 2015–2016 and 2016–2017
N = Number of women aged 50 to 74 years in population, 2016–2017.
- Data source: BreastScreen NSW (population data are sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).
- The participation rates presented here are expected to differ from figures published by the Australian Institute of Health and Welfare for the same period, due to variations in the population projections used in the denominator.
- The participation rates presented here are based on the number of women who live in NSW and are screened in NSW. Interstate clients have been excluded. Therefore the participation rates for border local health districts (Murrumbidgee, Southern NSW, Northern NSW) might be underestimated.
Why recommend BreastScreen NSW to patients?
- BreastScreen is a free, fully accredited service optimised for asymptomatic patients:
- Sensitivity and specificity is tightly controlled
- Robust, continuous quality assurance to ensure compliance with the evidence-based BreastScreen Australia National Accreditation Standards
- A formal read process is in place, meaning every mammogram is read by two radiologists, specialised in mammography. If these two reads do not agree, a third radiologist reads the mammogram.
- BreastScreen is equipped with the latest digital mammography equipment, ensuring that mammograms are of the highest quality, with minimal doses of radiation.
- If a woman needs to undergo assessment, BreastScreen will complete the assessment (using ultrasound, x-ray, examination and biopsy, as required) free of charge.
- BreastScreen NSW is the most appropriate screening option for asymptomatic women aged over 50 for whom there is no clinical findings.
More about BreastScreen NSW
A BreastScreen NSW GP request pad can be used to recommend breast screening to your patients.
BreastScreen NSW offers a range of brochures, posters and other printed materials for your practice.
Some women are apprehensive about having a mammogram. They may be embarrassed about the nature of the procedure, or feel anxious about pain or discomfort. By using practice data to identify eligible, under-screened patients, and supporting and encouraging them to participate in breast screening, you can make a difference to a woman’s decision to attend.
The following statements from you may help women prepare for their appointment, and may reduce their level of concern:
“The appointment will only take 20 minutes.”
“A female radiographer will help you get comfortable.”
“When you’re ready, the x-ray machine will press firmly on your breasts to take a picture.”
“Your breasts will only be compressed for a few seconds; twice for each breast.”
“You can talk to your radiographer about any discomfort or sensitivity. You can also ask them to stop the procedure at any time.”
If your patient requires further tests and has given their GP's details to BreastScreen NSW, the service will provide you with comprehensive information on her results. This will include progress updates during assesment and, if appropriate, details of diagnosis.
BreastScreen NSW is rolling out the delivery of electronic results across the state. Practices with compatible software can expect to receive a notification directly from BreastScreen NSW informing them of the date from which electronic results will be enabled.
Please note that Assessment Outcome Reports for clients who have undergone biopsy, or who require surgical management, will continue to be delivered via post/fax.
The pre-requisites to receive BreastScreen NSW results electronically include:
having an active account with Medical Objects or HealthLink
using either Medical Director or Best Practice software
being based in NSW or border-sharing locations.
Once secure messaging from BreastScreen NSW is enabled at your practice, the following results will be delivered electronically to your practice software, and will no longer be delivered via post:
Normal Result: No evidence of breast cancer detected
Normal Result: No evidence of breast cancer detected, but a breast change was reported; GP to follow up
Return to Assessment: Client to attend BreastScreen NSW Assessment Clinic
Assessment Outcome Report of clients who have NOT undergone biopsy.
If your practice does not have the above-mentioned prerequisites, it will be unaffected by this change and will continue to receive all BreastScreen NSW results via post/fax.
Many patients have questions for their GP on the difference between screening and diagnostic mammography. This information outlines the difference between these procedures.
Find out more about trans and gender diverse eligibility.
- The MBS item numbers used for private mammography are for investigation of clinical abnormality of the breasts.
- Diagnostic radiology is appropriate for:
- Diagnostic radiology is optimised to solve diagnostic problems. It has increased sensitivity and may have reduced specificity. This is appropriate for symptomatic women but may create a risk of over-biopsy in asymptomatic women.
- If a symptomatic woman is sent to BreastScreen and it is confirmed she does not have cancer, she will be required to return to a diagnostic screening pathway for diagnosis of the symptom.
- A woman screened via a diagnostic pathway cannot then come to BreastScreen for assessment, and may incur costs to complete her diagnoses.