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Breast Screening Programme

Why have a National Breast Screening Programme?

One woman in eight will suffer from breast cancer at some point in her life. Most of these will be above 50 and for this reason we shall be inviting all women between 50 and 60 to come forward for screening over the next three years. If the disease is caught at an early stage, there is a greater chance of less invasive treatment and complete recovery. The service being provided is free of charge; it is now up to you to participate when you receive your appointment in the mail. 

 
The Malta Breast Screening Programme provides free breast screening every three years for all women resident in the Maltese Islands aged 50 to 60 years. Around 14,000 women are being invited for screening each year.
 
 
What is breast screening?
 
Breast screening is a method of detecting breast cancer at a very early stage. The first step involves an x-ray of each breast - a mammogram - which is taken while carefully compressing the breast. Most women find it a bit uncomfortable and a few find it painful. The mammogram can detect small changes in breast tissue which may indicate cancers which are too small to be felt either by the woman herself or by a doctor. 
 
Certain conditions diagnosed through screening may never develop further or may grow so slowly that they would never cause harm during a woman’s life. Although this can result in unnecessary treatment and anxiety, it is currently recommended that all such conditions are treated, because it is not possible to determine how or which lesions will progress in the future.
 
 
What does the Malta Breast Screening Programme do?
 
The Malta Breast Screening Programme is an effective part of the Maltese Government’s efforts to reduce the death toll from breast cancer. Research has been published which demonstrates that screening programmes in other countries have lowered mortality rates from breast cancer. 
 
The programme is a rolling one which invites women from each age group in turn. In the coming year we plan to start with older women, and invite those aged 60 down to approximately 57 years, or those born between 1950 and 1953. This is the age where the risk is greatest. We will move down the age group to invite women between 54 and 57 in the second year (born 1954 to 1957), and then between 50 and 54, in the third year of the programme. In this way, all women aged between 50 and 60 over the next 3 year period or cycle will be invited. Women will be re-invited every 3 years until they reach the age of 60.

When was the Malta Breast Screening Programme set up ? 

The programme was set up by the Health Care Services Division within the Ministry for Social Policy in late 2007 in response to the recommendations of a specific working group. Government appointed a group of experts who have advised on setting up the Programme according to stringent quality standards as per European Guidelines 

The Malta Breast Screening Programme is nationally coordinated and sets national standards which are monitored through European quality assurance networks. The coordination office is based at 17, Lascaris Wharf, Valletta, opposite the old Customs building. 
 
 
How much does the programme cost ?

It is estimated that Government will spend 1.6 million euros to set up and equip the Malta Breast Screening Centre. The recurrent budget for the breast screening programme is now estimated to be approximately 0.5 million Euros. This works out at about 30 to 35 Euros per woman invited.
 
 
What is digital mammography ?

Recent developments in the breast screening field include the introduction of digital mammography, as will be used in the Malta Breast Screening Programme. There have been several studies regarding the acceptability by women of digital mammography. This has looked at their perceived pain or discomfort and levels of satisfaction with the experience when compared with conventional mammography. All women will have two views of the breast taken at every screen - one from above (craniocaudal) and one into the armpit diagonally across the breast (mediolateral). Research has shown that this increases small cancer detection rates considerably. Other benefits include a faster throughput and a significantly lower dose of radiation.
 
 
Why are we starting off by inviting women over 50 ?
 
There are two main reasons why women under 50 are not being offered routine screening through this Programme. Mammography is not as effective in pre-menopausal women (average age of menopause is 50) as the density of the breast tissue makes it more difficult to detect problems. As women go past the menopause, the glandular tissue in their breast "involutes" and the breast tissue is increasingly made up of only fat. This is clearer on the mammogram and makes interpretation of the x-ray more reliable. 
 
The incidence of breast cancer is also much lower in the pre-50 age group; breast cancer is more common in post-menopausal women and the risk continues to increase with rising age.
 
 
Does breast screening save lives ?

The World Health Organisation's International Agency for Research on Cancer (IARC) concluded that mammography screening for breast cancer reduces mortality. The IARC working group, comprising 24 experts from 11 countries, evaluated all the available evidence on breast screening and determined that there is a 35 per cent reduction in mortality from breast cancer among screened women aged 50 - 69 years old. This means that out of every 500 women screened, one life will be saved.
 
 
What do you do if you think you have a problem ?

Women can ask their GP to refer them to a hospital breast clinic if they are concerned about a specific breast problem or otherwise worried about the risk of breast cancer. This is not part of the Malta Breast Screening Programme, which uses a routine call and recall system to invite well women. However, the same techniques are used in both breast screening clinics and hospital breast clinics for diagnosing breast cancer and many staff work in both settings.
 
 
What happens during screening ?
A radiological examination or mammogram of the breast is taken by a radiographer (usually female). This takes only a few minutes to conclude, so in all your appointment should last about 20 minutes in all.
 
 
Do I need to call before I come for my appointment ?

You should immediately contact us on 2122 7470/1 if any of the following applies to you:
 
        1. If you would like to change your appointment
        2. If you use a wheelchair or have other difficulties with mobility
        3. If you are already being seen by a specialist for a breast condition
        4. If you have had a bilateral mastectomy and all breast tissue has been removed
        5. If you have already had a mammogram in the last 12 months.
 
 
Further information 

If you have any questions or difficulties regarding breast screening, please call us on 2122 7470, 21227471, or send an email , or Fax: 22910300. For any queries regarding your health, it is important to always seek advice from your family doctor or specialist.