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The Facts

  • Breast cancer is the second most common cause of cancer deaths in Australian women (after lung cancer) and is the most common cancer diagnosed in this group.
  • Early detection and treatment can significantly improve breast cancer survival, treatment options, and quality of life.
  • Mammography aims to detect breast cancer early before there are any clinical signs or symptoms, and is offered free to Australian women over 40 years of age through the BreastScreen program.
  • GPs play a critical role in promoting the BreastScreen program through conversations with their patients, dispelling myths and addressing common concerns. Test your knowledge of breast screening with these questions below.

Question: Is BreastScreen still operating during the COVID-19 pandemic?

Answer: BreastScreen has implemented several measures to ensure they are COVIDSafe. However, capacity within the BreastScreen program currently differs between states. Therefore, it is important that patients contact their local service by phoning 13 20 50 to make enquiries about appointment availability.

Question: Do women receive reminders from BreastScreen when they are next due for a mammogram?

Answer: BreastScreen will send an invitation to all women aged 50 – 74 years for a free, biennial mammogram. Women aged 40 – 49 years, and those over 74 years of age, are also eligible for a free mammogram, however they will not receive an invitation from BreastScreen.

Question: What is the radiation exposure involved with having a screening mammogram?

Answer: Mammograms use the smallest amount of radiation possible in order to produce a high-quality image. Screening mammograms, which are used for women with no breast symptoms, usually involve two x-ray images (superior and lateral views). The amount of radiation used is small, and is equivalent to 18 weeks of exposure to natural radiation in the environment. However, if you have a patient with breast symptoms, and refer them for a diagnostic mammogram at a public or private radiology clinic, more x-ray images are required.

Question: Are mammograms really that embarrassing and painful?

Answer: All radiographers involved in the BreastScreen program are female. The radiographer will need to firmly press their breast tissue between two plates on the x-ray machine. It is normal to feel discomfort for approximately 10 seconds for each breast while the procedure is being performed. If the patient experiences breast pain, they should notify the radiographer immediately as she can then release the pressure. Patients with breast implants, a disability, or those requiring an interpreter, should be encouraged to notify BreastScreen of these details when they make their appointment.

Question: Are there any resources available to support GPs discussing breast cancer risk with patients?

Answer: The RACGP “Red Book” has a useful section on discussing breast cancer risk and screening recommendations with patients. The Peter Callum Cancer Centre have also developed a web-based decision support tool called iPrevent, which patients can complete online prior to their appointment. After confirming some additional details during your consult with the patient, the tool will generate a personalised report which estimates your patient’s risk category and provides screening recommendations and preventative advice. This tool is not suitable for patients who have a history of invasive breast cancer or DCIS.

So…how did you go with answering these questions?? Patients trust their GPs with making decisions about their health, and it is important that you are equipped with the facts about breast screening. By promoting BreastScreen, and providing patients with accurate information about breast cancer risk and screening procedures, you can play your role in reducing breast cancer deaths in Australian women.

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References

Australian Government Department of Health. How breast screening works. https://www.health.gov.au/initiatives-and-programs/breastscreen-australia-program/having-a-breast-screen/how-breast-screening-works (Accessed June 2021).

Breast Cancer Network Australia. Breast cancer screening. https://www.bcna.org.au/breast-health-awareness/breast-cancer-screening/ (Accessed June 2021).

Cancer Council. A guide to: Breast Screening. https://www.cancer.org.au/cancer-information/causes-and-prevention/early-detection-and-screening/breast-cancer-screening (Accessed June 2021).

Peter MacCallum Cancer Centre. iPrevent: Information for Clinicians. https://www.petermac.org/iprevent/information-clinicians? (Accessed June 2021).