Restoration and recovery of the Breast Cancer Screening Programme
Routine breast cancer screening was temporarily paused from the second week in March 2020. This was in response to the COVID-19 pandemic. The Department of Health has now called for the phased restoration of all paused screening programmes. This has begun and routine breast cancer screening restarted from 20 July 2020.
The four month pause to date has resulted in a backlog of women awaiting screening. In addition, the screening programme will not be able to screen the same number of women as it did before the Covid-19 pandemic. This is due to the need for social distancing and appropriate infection control measures. It will therefore take many months to get the programme up and running at normal levels again.
Invitation for screening – helping you decide
You may have had your original appointment cancelled or postponed. We are now restarting breast cancer screening, but with the required social distancing measures and infection control procedures in place.
Your current mammogram appointment may be in a different location to where you would normally have had this carried out. This hopefully will be temporary while we work to restart and restore the programme.
If you or any members of your household have any symptoms of Covid-19, or are self-isolating, please do not attend your appointment. If this applies to you, please contact us to reschedule for a different time. Further information can be found online at: https://www.nidirect.gov.uk/articles/coronavirus-covid-19-overview-and-advice
What Infection control measures are in place?
We have implemented infection control measures in accordance with national guidance. Personal protective equipment (PPE) is used by the staff for every mammogram. Please wear a face covering to attend your appointment. If you wear disposable surgical gloves you will be asked to remove these and sanitise your hands before entering the breast screening unit. Equipment and furniture will be cleaned after each client and we have extended our appointment times accordingly.
What about social distancing?
We aim to reduce contact at appointments. We are asking you to confirm your appointment and that you come at the designated time, not earlier or later. To ensure your safety and the safety of others please observe the labelled socially distanced spots. Hand sanitisers are available prior to entering the unit. If your appointment is for the mobile, we would encourage people to remain in their vehicle until their appointment time where possible and to be prepared for a potential wait outside in any inclement weather. If your appointment is at the static unit please report to reception.
Can I bring someone with me to my screening appointment?
We would ask that, where possible, clients attend their appointments on their own. In exceptional circumstances it may be possible to have a carer or comforter present but please contact the unit discuss this before you attend.
What can I do while I wait for my screening appointment?
It’s important to be symptom aware. See your GP if you notice any changes that aren’t normal for you, especially if the changes are only in one breast.
Breast changes to look out for include:
- changes in appearance, size or outline of either breast, especially those caused by arm movement
- any puckering, dimpling or redness of the skin or veins that stand out more than usual
- pain or discomfort in one part of either breast or armpit, particularly if new and persistent
- any lumps or thickening in either breast that feels different from the other breast
- any swelling or lumps under your armpit or around your collarbone
- changes to your nipples, including nipples that have become pulled in, changed shape or show signs of discharge, bleeding, rash or crusted, flaky skin
These symptoms don’t mean that you have breast cancer, but if you have them, make an appointment to see your GP immediately.
I have been invited to attend for further assessment. Should I still attend my appointment?
Yes. It is important that you attend your assessment appointment. If you are concerned about attending, or you’d like to discuss your attendance with a member of our clinical team, please phone the breast screening unit. The number to phone is on your assessment letter. In addition, the contact numbers for each of the breast screening unit are given below. Please quote your SX number, beginning with CS0, on any correspondence (located on bottom left hand corner of the invitation letter). Also note due to Covid-19 restrictions, refreshments in the waiting area will not be available at this time.
If you, or any members of your household, are experiencing Covid-19 symptoms, or are self-isolating, please do not attend your appointment. If this applies to you, please contact your breast screening unit to reschedule for a different time.
In exceptional circumstances it may be possible to have a carer or comforter present. Please contact us on the telephone number on your assessment letter to discuss this. In most cases you will have all your tests performed and results will be given on the day.
I normally attend the Very High Risk Breast Surveillance Screening Programme; will I still be called for my appointment?
This programme was not paused and has continued to run as normal. Women who require mammography only may have their screening at their local breast screening unit. This option was paused as part of the response to Covid-19, but was reinstated from September 2020.
If you or any members of your household are experiencing Covid-19 symptoms, or are self-isolating, please do not attend your appointment. If this applies to you, contact the Unit at Antrim Hospital to reschedule for a different time. Please quote your SX no. beginning with CS0 on any correspondence (located on bottom left hand corner of the invitation letter).
I am over 70 can I still self-refer?
Yes. We have re-introduced breast cancer screening for women over 70 who self-refer. However, this position will be kept under review in light of further impact of the Covid-19 pandemic.
Eastern Area Breast Screening Unit
Northern Area Breast Screening Unit
Western Area Breast Screening Unit
Southern Area Breast Screening Unit
The breast screening programme covers the whole of Northern Ireland. The programme invites women by GP practice every three years. A woman might be aged 50, 51 or 52 when she receives her first invite to attend – the first invitation will be before the age of 53.
In order to be invited women must ensure that their GP has their correct name and current address on their computer system.
When you receive an invitation to attend for breast screening:
- Read the information leaflet that comes with the invitation. It is called Breast screening can save lives
- If you want more information or advice speak with your GP
- If you have special requirements speak to the breast screening unit
- Plan in advance how you will get to the appointment on the day, including transport, time off work, someone to look after the children or other dependents and consider whether you want to bring a companion.
- If the appointment doesn’t suit you phone the breast screening unit and arrange to attend at a different time
Increasing the number of women who participate in breast screening is vital in reducing the number of women dying from breast cancer. In Northern Ireland women aged 50 to 70 are invited to attend every three years. However, about 25% of women invited do not attend for screening. There are a variety of reasons why some women may not attend, including the way the programme is organised, poor communication or to individual factors (personal circumstances).
A well organised system for inviting women to attend for breast screening improves uptake. In Northern Ireland we have had a good call and recall computer system operating for many years. This system is called the National Breast Screening System (NBSS). In order to be able to produce invitation letters it needs to be able to identify women who are aged 50 – 70 and have up to date contact information. Until recently this information was cross checked manually with the information held by GPs.
In November 2010 an electronic link was established between NBSS and the computer system that supports primary care. The link means that the most up to date contact details are now readily available to the breast screening programme. The whole process of course depends on the GP computer system being completely accurate.
A series of information leaflets is available on the publications section of this website by clicking here
For more information on breast screening please also see www.cancerscreening.hscni.net.
The Breast Screening programme has produced a video to show what happens when women attend their appointment for a mammogram. To view the video click here: http://www.cancerscreening.hscni.net/Breast%20Screening%20video.htm
Video for women with learning disabilities
The Clinical Nurse Specialist team at Avon Breast Screening has in collaboration with Biggerhouse film, produced a film by and for women with learning disabilities, to take the fear out of going for breast screening.
This is a breast screening film for women with learning disabilities, showing clearly what happens during the process of having a mammogram. Whilst breast screening is always an individual choice, the film is intended to take the fear out of going for breast screening and encourage women with learning disabilities to come and have the test.
The film can be watched in full, or in short segments, showing different aspects of the screening journey;
Breast surveillance screening for women with a very high risk of breast cancer
Breast surveillance screening is offered to women who have been assessed by a specialist in genetics, family history or oncology and are considered at very high risk of breast cancer. Women may have an increased risk of developing breast cancer because of a genetic disorder (usually BRCA) or because they had radiotherapy to their chest when younger.
Women in the Very High Risk Breast Surveillance Screening Programme may:
- be offered annual mammography, MRI, or both, depending on age and specific level of risk
- begin screening at an earlier age than routine breast screening
- attend for screening at a Specialist Imaging Unit in Antrim Area Hospital
- arrange to attend their local screening unit for surveillance screening (if only mammography screening is required)
In September 2020, the programme title was changed to reflect national guidance. Although the title changed from the ‘Higher Risk Breast Surveillance Screening Programme’ to the ‘Very High Risk Breast Surveillance Screening Programme’, this does not indicate any increase in cancer risk for those in the programme.
If you think you may have an increased risk of breast cancer talk to your GP so you can be referred to a hospital Family History Clinic. The clinic may refer you for genetic testing if they feel it's appropriate.
Patient information leaflet for the Very High Risk Breast Screening Programme
The Very High Risk Breast Screening Unit at Antrim Hospital may be contacted on: 028 9442 4426
BRCA Link NI is a voluntary organisation helping people to access information and support about BRCA genetic mutations whilst raising awareness of Hereditary Cancers linked within families who are at risk www.brcani.co.uk, firstname.lastname@example.org.
For more information on breast cancer genetics, including a support telephone line, please visit: www.breastcancergenetics.co.uk