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Breast Screening Programme

Why was the Breast Screening Programme set up?
In Malta, around 300 women are diagnosed with breast cancer each year. If breast cancer is detected at an early stage, there is a greater chance of successful treatment or recovery. The aim of breast screening is to find breast cancers early, when they are still too small to see or feel.

When am I eligible for breast screening?
Breast screening is currently offered to all women aged between 50 and 68 years of age (for 2019, this includes those born between 1950 and 1969) every two and a half years. This is in view of the fact that most cases of breast cancer occur in women above 50 years of age.

What does the screening test involve? What will happen on the day?
Breast screening involves having a mammogram, which is an X-ray of the breasts. The screening mammogram is carried out at the National Screening Centre by a female radiographer. It involves compression of the breast for a few seconds. The mammogram takes a few minutes to be carried out, so a breast screening appointment generally lasts about 30 minutes in all.

On arriving at the Screening Centre, reception staff will require a means of identification such as ID card, driving licence or passport to confirm your details.  When you are called in to the mammography room by the radiographer they will start by explaining the procedure and giving you some time to undress to the waist. The radiographer will then place your breast on the mammogram machine and gently but firmly lower a plate onto it. This helps keep the breast in place to ensure the mammogram images are clear. In most cases two images of each breast are taken, one from above and one from the side of the breast. While an image is being taken, the radiographer will move behind a screen. During this brief time, you will be asked to keep still so that the x-ray image is not distorted.

Compression of the breast is necessary for the images to be clear. Most women describe the procedure as uncomfortable, a few find it painful. The discomfort is brief as compression is only maintained for a few seconds for each image.

What are the potential benefits and risks of breast screening?
Most experts agree that regular breast screening is beneficial in recognising breast cancer early. A 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. The earlier breast cancer is diagnosed, the greater the chance of survival. If breast cancer is detected at an early stage it is also less likely that you will need a mastectomy (removal of the breast) or chemotherapy.

The main risk of breast screening is that it may also pick up cancers that would never have gone on to cause symptoms or become life-threatening. This may result in unnecessary tests and treatment as well as anxiety. There is also very small risk that a cancer diagnosis might be missed on screening (the person who is screened is given an all-clear result when there is in fact a tumour). Mammography is a type of x-ray and it involves exposing the breasts to a small amount of radiation. This is significantly less than the natural background radiation that a person is exposed to in one year. The benefits of screening are generally considered to outweigh the risks from this small dose of radiation.

Evidence from international research estimates that for every 200 women screened, breast screening saves the life of one woman and results in three women being diagnosed with a cancer that would never have become life-threatening.

Do I need to call before I come for my appointment?
You should contact the Screening Unit on 2122 7470/1 before your appointment in these cases:
  • If you would like to change your appointment
  • If you have had a mammogram in the last 12 months
  • If you are pregnant or breastfeeding
  • If you are already being seen by a specialist for a breast condition
  • If you have had a bilateral mastectomy and all breast tissue has been removed
  • If you have a physical disability that may make it difficult for you to be positioned on the X-ray machine and hold that position for several seconds (you will need to support your upper body without assistance)

Is there anything I need to do to prepare for breast screening?
On the day of the mammogram:
  • Do not use deodorant, talc or creams around the breast area
  • Since you have to undress to the waist for the mammogram to be carried out, you may prefer to wear a skirt or trousers instead of a dress
  • Bring your identity card and the contact details (name and telephone number) of your family doctor with you
  • Bring any previous mammograms taken in the private sector if available (e.g. mammograms stored on CD)
  • Non-Maltese residents are required to present the European Health Insurance Card or a recent payslip showing National Insurance contribution 
  • If you have breast implants or think you might be pregnant, inform the radiographer before taking the mammogram

When will I know my results? What happens next?
Screening mammograms are reviewed by two radiologists. In the case of normal results, these are sent to you by post after around three weeks. A copy will also be sent to your family doctor if you have provided their details to the screening programme.

In some cases, further tests may be required because mammogram images were unclear or an abnormality is suspected. In these situations, you will be contacted by phone and given an appointment to attend the weekly recall clinic. Being asked to attend the recall clinic does not mean that you have breast cancer.

At the recall clinic further mammogram images breast ultrasound and if necessary even a biopsy (taking a sample of breast tissue using a specially-designed needle) may be taken, according to the individual case. Imaging results are reviewed by a radiologist during the recall clinic and you will be informed of the result shortly after the images are taken. Biopsy results are issued after 1-2 weeks as these need to be sent to Mater Dei Hospital and processed by the pathology laboratory.  If a biopsy is taken, you will be given an appointment to discuss the biopsy results with a breast surgeon at the Screening Centre.

If you are diagnosed with breast cancer, you will be referred to the Breast Clinic at Mater Dei Hospital for specialised care. The breast screening team will liaise with the hospital team to pass on details of your case and arrange an urgent follow-up appointment.

I’ve noticed something abnormal in my breast. What should I do?
The Breast Screening Programme is a screening service that offers scheduled appointments for women who are well and does not offer a walk-in service for women experiencing breast symptoms. If you have noticed anything unusual in your breasts that you are concerned about do not wait for your screening appointment, speak to your family doctor. Your doctor may refer you to the Breast Clinic at Mater Dei Hospital. 

I have a strong family history of breast cancer and am concerned about my risk of getting breast cancer. What should I do?
If you have a family history of breast cancer, you may have a higher risk of developing breast cancer than average. Speak to your family doctor, who may decide to refer you for genetic testing according to your specific situation.

I fall within the age group eligible for breast screening, but I have not received an invitation. What should I do?
If you fall within the age group eligible for screening (50 to 68 years of age) but have not received a screening invitation, you can call the Screening Centre for an appointment. 

Who can I contact if I have any questions about breast screening?
If you have any questions or difficulties regarding breast screening, please call the Screening Centre on 2122 7470/1, send an email on breast.screening@gov.mt​, or pay us a visit.  

The Screening Centre’s address is:  17, Lascaris Wharf, Valletta, VLT 1921.