Showing posts with label Breast. Show all posts
Showing posts with label Breast. Show all posts

Breast reduction on the NHS

Breast reduction on the NHS

Breast reduction surgery can help women who are unhappy with the shape, weight or droop of their breasts by making them smaller and more lifted.
But if it's done to improve appearance rather than for health reasons, it's not normally available on the NHS. Instead, you'll need to pay for the procedure privately.
Information about breast reduction for cosmetic reasons is provided elsewhere.
This page focuses on when breast reduction might be available on the NHS.

Eligibility criteria for NHS breast reduction

The availability of breast reduction surgery on the NHS varies, depending on the eligibility criteria decided by your local clinical commissioning group (CCG).
Some CCGs do not fund breast reduction surgery at all, and others fund it selectively if you fulfil certain criteria.
Generally speaking, you might be considered for breast reduction on the NHS if you have problems caused by having very large breasts, such as:
  • backache 
  • shoulder or neck pain
  • skin irritation
  • rashes and skin infections under the breasts
  • grooves on the shoulders from bra straps
  • psychological distress, such as low self-esteem or depression
  • an inability to exercise or take part in sports
CCGs also tend to have additional criteria that may include the size of your breasts, your weight, your age, whether you smoke, and whether other options (such as wearing professionally fitted bras) have been tried, but have not helped.
You can find out what the eligibility criteria are in your area from your GP or by contacting your local CCG.

The referral process

See a GP if you think you might be eligible for breast reduction surgery on the NHS.
They can check whether you meet the criteria of your local CCG and, if you do, they can refer you to a breast or plastic surgeon for an assessment.
This may involve:
  • asking about the problems you're having
  • checking your weight and general health
  • an assessment by a psychiatrist or psychologist
  • information about the risks and results of surgery
The assessment will help determine whether you're suitable for surgery and whether there's a strong enough reason for this to be done on the NHS.
The final decision is usually made by a panel of representatives from your local CCG, which will take into account the information from your assessments and a review of your individual case.

Things to consider before you go ahead

It's important to discuss your problems and options with a GP and an appropriately qualified surgeon before having a breast reduction.
This will help you get a clear idea of what changes you can expect to see and ensure you're aware of any risks involved.
Be aware that:
  • a significant reduction can alter the shape and look of your breasts
  • there will be scarring and possibly lost or altered nipple sensation
  • your breasts can change in size and shape after surgery – for example, they may increase or decrease in size if you put on or lose weight
  • breasts have a tendency to droop over time
  • your breasts can get bigger during pregnancy and you may not be able to breastfeed after surgery – so you may need to wait until you're sure you do not want to have any more children
For women with very large breasts, the benefits of a reduction may outweigh any potential problems.
But for women with only moderately large breasts, the benefits may not be worth the risks.

Alternatives to breast reduction surgery

It's sometimes possible to reduce problems caused by having large breasts without the need for surgery.
The following measures may help:
  • if you're overweight, losing weight can sometimes help reduce the amount of fatty tissue in your breasts
  • a professional bra-fitting service – for many women with problems caused by large breasts, getting a professional to fit a correctly-sized bra can reduce discomfort
  • physiotherapy – exercises from a physiotherapist can sometimes help with aches and pains caused by large breasts
  • psychological support and treatment – this can help if your large breasts are causing emotional or mental health issues
Breast reduction surgery will usually only be available on the NHS if you have first tried alternative measures.

Male breast reduction on the NHS

Male breast reduction is not normally available on the NHS.
This is because enlarged breasts in men are usually a result of being overweight, and losing weight will often help to reduce their size.
You'll normally need to pay privately for breast reduction surgery in these cases.
But breast reduction on the NHS may sometimes be considered if it's caused by an underlying condition, or if losing weight has not helped.
A GP can advise you about whether you might be suitable for surgery on the NHS.

More information

For more about the operation and what to expect afterwards, see our topics on cosmetic breast reduction surgery and male breast reduction.


Labels: ,

Breast pain

Breast pain

There are many reasons breasts can be painful. Breast pain by itself is unlikely to be a symptom of cancer.

Breast pain is usually linked to periods

Symptoms of breast pain caused by periods:
  • dull, heavy or aching pain – from mild to very bad
  • pain that begins up to 2 weeks before a period, gets worse and then goes away when the period ends
  • usually (but not always) affects both breasts and sometimes pain spreads to the armpit

How to ease the pain yourself

You can:
  • take paracetamol or ibuprofen, or rub painkilling gel on your breasts
  • wear a properly fitted bra during the day and a soft bra to sleep in
There's little evidence that vitamin E tablets or evening primrose oil help with breast pain.

Breast pain not linked to periods

Sometimes breast pain is caused by:
  • injuries or sprains to the neck, shoulder or back – these can also be felt as breast pain
  • medicines like the contraceptive pill and some antidepressants – check the side effects in the packet's information leaflet
  • conditions like mastitis or a breast abscess – these can cause breast pain along with other symptoms
  • pregnancy – breast pain can be an early sign

Breast pain and the menopause

Hormone changes during the menopause can cause breast pain.
Once the menopause is over (you have had 12 months without a period) the pain should not return.

Non-urgent advice:See a GP about breast pain if:


  • it's not improving or painkillers are not helping
  • you have a very high temperature or feel hot and shivery
  • any part of your breast is red, hot or swollen
  • there's a history of breast cancer in your family
  • you have any signs of pregnancy – you could do a pregnancy test first

Urgent advice:Get advice from 111 now if:


  • there's a hard lump in your breast that does not move around
  • you get nipple discharge, which may be streaked with blood
  • 1 or both breasts change shape
  • the skin on your breast is dimpled (like orange peel)
  • you have a rash on or around the nipple, or the nipple has sunk into the breast
These can be signs of something more serious.
111 will tell you what to do. They can arrange a phone call from a nurse or doctor if you need one.
Go to 111.nhs.uk or call 111.



Page last reviewed: 28 June 2017
Next review due: 28 June 2020




Labels: , ,

Breast lumps

Breast lumps

If you feel a lump in your breast, you should always get it checked by a GP. Most breast lumps are harmless but some can be serious.

Non-urgent advice:See a GP if you notice:


  • a lump in your breast or armpit
  • any other unusual changes in your breasts – such as the nipple turning inwards, dimpled skin or bloodstained nipple discharge
Changes in the breasts can be a sign of breast cancer. This is easier to treat if it's found early.

What happens at your GP appointment

The GP will look at and examine your breasts.
If they're not sure what's causing the lump, they'll refer you to a hospital or breast clinic for further tests.
These tests usually show that a lump isn't cancer.

What happens at the breast clinic

At the hospital or breast clinic, you may have a:
  • breast examination
  • scan – usually a breast X-ray (mammogram) or ultrasound
  • biopsy – where a needle is inserted into the lump to remove some cells for testing
These tests are often done during the same visit. You'll usually be told the results on the same day, although biopsy results take longer – you should get them within a week.
Breast Cancer Care has more information about what to expect at a breast clinic appointment.
Treatment for a lump depends on the cause. Most are harmless and may go away on their own without treatment.

Causes of breast lumps

Lumps in the breasts can have lots of different causes.
Most are due to something harmless, such as a non-cancerous tissue growth (fibroadenoma) or a build-up of fluid (breast cyst).
But sometimes they can be a sign of something serious, such as breast cancer.
Don't try to self-diagnose the cause of your lump – always see a GP.


Labels: ,

Breast cancer screening - FAQs

FAQs-Breast cancer screening


I haven't been called for breast screening even though I'm over 50. Do I need to contact anyone?

The NHS Breast Screening Programme calls women from doctors' practices in turn.
This means not every woman receives her invitation as soon as she is 50. It'll be some time between the ages of 50 and 53.
If you're registered with a GP and the practice has your correct details, you'll automatically receive an invitation.
You don't need to contact anyone, but you might like to ask your surgery when the women on their list are next due for screening.
Read more about when screening is offered.

I've found a lump in my breast. Can you tell me how I can get a mammogram?

The NHS Breast Screening Programme is a population screening programme that invites all women from the age of 50 to their 71st birthday as a matter of routine. It isn't aimed at women who already have symptoms.
If you have found something that worries you, don't wait to be offered screening – see your GP. He or she will decide whether or not you need to be referred for further investigations or treatment.
Read more about the symptoms of breast cancer.

My sister lives abroad and she gets more frequent breast screening. Why doesn't this happen in the UK?

A large research trial in 2002 concluded that the NHS Breast Screening Programme has got the interval between screening and invitations about right at 3 years, compared with more frequent screening.
The trial was organised through the United Kingdom Coordinating Committee on Cancer Research (UKCCCR) and was supported by the Medical Research Council, Cancer Research UK and the Department of Health.
The results from the UKCCCR Randomised Trial are published in the European Journal of Cancer, 2002.

I'm worried that breast screening will hurt because of the size of my breasts...

Don't worry. The mammography practitioners are used to screening women of all sizes and will do their best to minimise any discomfort.
Research has shown that for most women it's less painful than having a blood test and compares with having blood pressure measured.
For women with very large breasts, additional pictures are sometimes needed to ensure that all the breast tissue is included.

Can I walk into the mobile breast screening unit and request a mammogram?

No – the NHS Breast Screening Programme doesn't operate on a walk-in basis. It invites women in the target age group (from 50 to their 71st birthday) for routine breast screening every 3 years.
If you're concerned about your breast health, contact your GP.

Why does breast screening stop at 70?

It doesn't. Although women over 71 and over aren't routinely invited for breast screening, they're encouraged to call their local breast screening unit to request breast screening every 3 years.

Can women with a physical disability be screened?

If you have a disability, contact the breast screening unit before your appointment.
Mammography is a procedure that's technically difficult. You have to be carefully positioned on the X-ray machine, and must be able to hold the position for several seconds.
This may not be possible for women with limited mobility in their upper bodies or who are unable to support their upper bodies unaided.
If you have a disability, your breast screening unit should be able to advise you if screening is technically possible, and on the most appropriate place to be screened. This will usually be at a static unit.
If a mammogram isn't technically possible, you should still remain in the call and recall programme, as any increased mobility at a future date may make screening easier.
If a woman can't be screened, she should be advised on breast awareness.

I am a carer looking after someone who lacks the mental capacity to make their own decisions about screening. They have been invited for breast screening. How should I deal with their invitation?

If the person you care for is unable to make their own decisions about screening, then you, as their carer, should make a "best interests" decision on their behalf.
You'll need to weigh up the benefits of screening, the possible harm to them, and what you think the person would have wanted to do themselves.
You can speak to the person's GP for advice if the person you care for doesn't have the capacity to give their consent.
For example, if they're unable to:
  • understand the screening process
  • make a decision about being screened
  • communicate their wishes
The GP will have access to the person's medical records and knowledge of their overall medical health.
You can ask them about the person's risk of developing the cancer in question, and how screening might affect them.
You should also consider what you think the person themselves would want.
For example:
  • Did they used to go to screening, or express an opinion about it?
  • Did they express more general views about their health and whether they'd want to know if they had a disease or condition?
  • Did they refuse screening in the past?
Paid carers in particular should get advice from family members or friends about the person's views.
If, after all this, you consider that screening is in the best interests of the person you care for, you're within your rights to help that person to be screened.
To help someone with limited capacity understand the screening process, you may find the picture leaflet An easy guide to breast screening helpful.
For more information on making a decision in someone's best interests, see Making decisions: a guide for family, friends and other unpaid carers.

I'm in the process of changing from a man to a woman. I'm over 50. Am I entitled to breast screening?

Individuals who are undergoing male to female gender reassignment may be screened as a self-referral at the request of their GP. If you have a symptom, you should see your GP in the usual way.
If you're going through male to female gender reassignment and are registered as male with your GP, you won't be invited for breast screening.
But if you hae been on long-term hormone therapy, you may be at increased risk of breast cancer. Talk to your GP about referral for a mammogram.

I'm changing from a woman to a man. Will I still be offered breast screening?

If you're going through female to male gender reassignment, you'll continue to be invited for breast screening as long as you're registered as female with your GP, unless you ask to be removed from the programme or have had both breasts removed.
You can read more in Public Health England's leaflet about NHS Screening Programmes for trans people (PDF, 2.57Mb).

What happens to my mammograms after screening?

The NHS Breast Screening programme will keep your mammograms for at least 8 years. These are saved securely.
The screening programme regularly checks records to make sure the service is as good as possible.
Staff in other parts of the health service may need to see your records for this, but your records will only be shared with people who need to see them.
If you want to know the results of these regular checks, you can contact your local screening unit.


Labels: , , ,

Breast cancer screening - Your Results

Your results-Breast cancer screening


After your breasts have been X-rayed, the mammogram will be checked for any abnormalities.
You'll receive a letter with your breast screening results within 2 weeks of your appointment. The results will also be sent to your GP.
There are 3 types of results you can get:

Satisfactory result

This means the mammogram showed no sign of cancer. You'll be invited to screening again in 3 years.
Remember that cancer can still develop between mammograms, so tell your GP straight away if you notice any breast changes.
Read about the symptoms of breast cancer.
About 96 out of every 100 women screened get a satisfactory result.

Some women will need more tests because they have an abnormal result

The results letter may say you need more tests because the mammogram looks abnormal.
If you're called back for more tests, you may have a breast examination, more mammograms and ultrasounds.
You may also have a biopsy, which is when a small sample is taken from your breast with a needle to be checked under a microscope.
You'll usually get your results within a week.
One in 4 women with an abnormal screening result will be found to have cancer.
The rest won't have cancer and will go back to having screening invitations every 3 years.

Unclear result

Sometimes technical problems mean the mammogram isn't clear enough to read.
If this happens, you'll be asked to have another mammogram to get a clearer picture of your breast.

If you have breast cancer

If breast cancer is found, it could be either non-invasive or invasive.

Non-invasive breast cancer

About 1 in 5 women diagnosed with breast cancer through screening will have non-invasive cancer.
This means there are cancer cells in the breast, but they're only found inside the milk ducts (tubes) and haven't spread any further. This is also called ductal carcinoma in situ (DCIS).
In some women, the cancer cells stay inside the ducts. But in others, they'll grow into (invade) the surrounding breast in the future.
Doctors can't tell whether non-invasive breast cancers will grow into the surrounding breast or not.

Invasive breast cancer

About 4 in 5 women diagnosed with breast cancer through screening will have invasive cancer.
This is cancer that's grown out of the milk ducts and into the surrounding breast.
Most invasive breast cancers will spread to other parts of the body if left untreated.


Labels: , , ,

Breast cancer screening - What happens

What happens-Breast cancer screening


Breast screening involves having an X-ray (mammogram) at a special clinic or mobile breast screening unit. This is done by a female health practitioner called a mammographer.
You should call your breast screening unit (contact details will be on your invitation letter) before your appointment in certain situations:
  • If you have a physical diasbility or find climbing steps difficult. This is so your screening unit can make any necessary arrangements for you.
  • If you have breast implants. Mammography can be less effective in women who have breast implants because the X-rays can't "see" through the implant to the breast tissue behind it. You'll usually be able to have a mammogram, but let the screening staff know beforehand. Read an NHS leaflet about breast implants and breast screening.
  • If you have had a mammogram recently, or are pregnant or breastfeeding. You may be advised to delay breast screening.

What happens on the day

When you arrive at the breast screening unit, the staff will check your details and ask you about any breast problems you have had. You can also ask any questions you may have.
You'll need to undress to the waist, so it may be easier to wear a skirt or trousers instead of a dress.
First, the mammographer will explain what will happen. She'll then place your breast onto the mammogram machine and lower a plastic plate onto it gently but firmly to flatten it. This helps keep your breast still and ensures a clear X-ray.
The mammographer will usually take 2 X-rays of each breast – one from above and one from the side.
She'll go behind a screen while the X-rays are taken. You have to keep still for several seconds each time.
Most women find the procedure uncomfortable and it can occasionally be painful.
But the compression is necessary to ensure that the mammogram is clear. Any discomfort will be over quickly.
The whole appointment takes less than half an hour and the mammogram takes a few minutes.

Results

After your breasts have been X-rayed, the mammogram will be checked for any abnormalities.
The results of the mammogram will be sent to you and your GP within 2 weeks of your appointment.


Labels: , , ,

Breast cancer screening - When it is offered

When it's offered-Breast cancer screening


Women in England who are aged from 50 to their 71st birthday and registered with a GP are automatically invited for screening every 3 years.
But the NHS is in the process of extending the programme as a trial, offering screening to some women aged 47 to 73.
You'll first be invited for screening within 3 years of your 50th birthday, although in some areas you'll be invited from the age of 47 as part of the age extension trial.
If you want to change the appointment you have been given, contact the name and address on your invitation letter.
You may be eligible for breast cancer screening before the age of 50 if you have a very high risk of developing breast cancer.
If you're 71 or over, you'll stop receiving screening invitations.
But you're still eligible for screening and can arrange an appointment directly with your local breast screening unit.

How do I opt out of breast screening?

If you don't want to be invited for breast screening in the future, contact your GP or your breast cancer screening unit and ask to be removed from their list of women eligible for screening.
You'll need to sign a form to say you don't want to be invited anymore.
If you change your mind at a later date, you can simply ask your GP or screening clinic to put you back on the list.

If you have a family history of breast cancer

If you think you may have an increased risk of breast cancer because you have a family history of breast cancer (female or male) or ovarian cancer, talk to your GP so you can be referred to a hospital high-risk clinic.
The clinic may refer you for genetic testing if they feel it's appropriate.

Screening for women at high risk of breast cancer

If you have been found to have an increased risk of developing breast cancer, you may have yearly MRI scans or mammograms, depending on your age and your specific level of risk.
MRI scans are sometimes used instead of mammograms because they're better at detecting cancer if you have dense breast tissue.

Private breast screening

NHS screening programmes care for you throughout the whole screening process, including further treatment and care if you need it.
In the case of private screening, the care and treatment you may need after screening may not be available from the provider.
You can, however, be referred back into the NHS at any time should a private mammogram be abnormal.
For more information, read the NHS leaflet Thinking of having a private screening test?


Labels: , , ,

Breast cancer screening - Benefits and risks

Benefits and risks-Breast cancer screening




The NHS offers screening to save lives from breast cancer. Screening does this by finding breast cancers at an early stage, when they're too small to see or feel.
But it does have some risks.
Screening also doesn't prevent you getting breast cancer, and it may not help if you already have advanced stage breast cancer.
It's up to you to decide if you want to have breast screening.

Benefits of breast screening

Breast screening helps identify breast cancer early. The earlier the condition is found, the better the chances of surviving it.
You're also less likely to need a mastectomy (breast removal) or chemotherapy if breast cancer is detected at an early stage.

Risks of breast screening

Overtreatment

Some women who have screening will be diagnosed and treated for breast cancer that would never have otherwise caused them harm.
Read about breast cancer treatment, including potential side effects.

Unnecessary distress

Following screening, about 1 in 25 women will be called back for further assessment.
Being called back doesn't mean you definitely have cancer. The first mammogram may have been unclear.
Most women who receive an abnormal screening result are found not to have breast cancer. These women may experience unnecessary worry and distress.
About 1 in 4 women who are called back for further assessment are diagnosed with breast cancer.

Missed diagnosis

There's a small chance that you'll receive a negative (all clear) mammogram result when cancer is present.
Breast screening picks up most breast cancers, but it misses breast cancer in about 1 in 2,500 women screened.

Radiation

A mammogram is a type of X-ray, and X-rays can, very rarely, cause cancer.
During a mammogram, your breasts are exposed to a small amount of radiation (0.4 millisieverts, or mSv).
For comparison, in the UK, a person receives a dose of 2.2 mSv a year from natural background radiation.
But the benefits of screening and early detection are thought to outweigh the risks of having the X-ray.

Weighing up the possible benefits and risks of breast screening

There's debate about how many lives are saved by breast screening and how many women are diagnosed with cancers that wouldn't have become life threatening.
The numbers below are the best estimates from a group of experts who have reviewed the evidence.

Saving lives from breast cancer

Screening saves about 1 life from breast cancer for every 200 women who are screened.
This adds up to about 1,300 lives saved from breast cancer each year in the UK.

Finding cancers that would never have caused a woman harm

About 3 in every 200 women screened every 3 years from the age of 50 to 70 are diagnosed with a cancer that would never have been found without screening, and would never have become life threatening.
This adds up to about 4,000 women each year in the UK who are offered treatment they didn't need.

What this means

Overall, for every 1 woman who has her life saved from breast cancer, about 3 women are diagnosed with a cancer that would never have become life threatening.
Researchers are trying to find better ways to tell which women have breast cancers that will be life threatening and which women have cancers that won't.

Who's at higher risk of breast cancer?

The causes of breast cancer aren't fully understood, making it difficult to say why one woman may develop breast cancer and another may not.
But there are risk factors known to affect your likelihood of developing breast cancer.
Some of these you can't do anything about, but there are some you can change.
Labels: , , ,
Subscribe to: Posts (Atom)