VIEWS: 0 PAGES: 37 POSTED ON: 3/17/2012
Having a Breast Test Professional Pack Version 3 – April 2011 Having a Breast Test A Guide for Health Professionals • This guide has been developed for use in conjunction with the: Having a Breast Test An Information Pack for Women with a Learning Disability Aims of the Guide • To provide health professionals with a background knowledge of the Breast Screening Programme • To assist health professionals to educate other members of their team, to deliver information on the breast screening process to their clients • Provide useful website links for staff to access further information as required How to use this Guide • Before using the teaching pack with your client, you will need to work through the professional pack • The professional pack allows you to develop your own knowledge base, at your own pace • Each slide provides the key messages relating to breast screening • For more detailed information follow the relevant website links • To open the links, click on the hyperlink, you will be directed to the relevant site • N.B Hyperlinks will only be active when you are using the guide online About Breast Test Wales • Breast Test Wales is responsible for the delivery and quality of breast screening throughout Wales • It is part of Public Health Wales, NHS Trust, Screening Division • The programme has been established since 1989 • The aim of the programme is to reduce the number of deaths from breast cancer among women we screen. http://www.screeningservices.org.uk/btw Organisation chart Public Health Wales NHS Trust Screening Division Cervical Bowel Newborn Breast Test Antenatal Screening Screening Hearing Wales Screening Wales Wales Screening What is Breast Cancer? • Click here www.cancerresearchuk. org A – cancer cell B – basement membrane Source: breastcancer.org Principles of Screening • Screening provides an opportunity to reduce the risk of contracting a disease or suffering its complications. • The breast screening programme reduces the risk of dying from breast cancer. http://www.nsc.nhs.uk General principles of screening 1. The condition screened should pose an important health problem 2. The natural history of the condition should be well understood. 3. Recognisable latent or early stage 4. Treatment of the disease at an early stage should be more beneficial than treatment started at a later stage. General principles of screening 5. Suitable test or examination 6. Acceptable to the population 7. Screening should be repeated at intervals determined by the natural history of the disease General principles of screening 8. Adequate diagnostic and treatment facilities 9. The cost - should be economically balanced against the benefit it provides. 10. The chance of physical or psychological harm should be less than the chance of benefit. Wilson Jungner criteria  Screening • We recommend that screening should be seen as a risk reduction programme, rather than a prevention programme in order to reduce the psychological impact of issues such as receiving false negative results. Screening is not fool proof but it must be recognised that it does save lives and often significantly improves quality of life by early diagnosis of serious conditions.’ (Dr Muir Gray: Network 2000 Issue 38) www.cancerresearchuk.org Disadvantages of Screening • Cancer can occur between screens. • Screening does not prevent breast cancer. • Screening is not 100% effective. • It will not detect all cancers. • Some women will have unnecessary investigations. • Discomfort • Radiation. Advantages of Screening • Screen detected cancers are significantly smaller than symptomatic cancers. • Earlier treatment. • Less radical treatment. Informed Choice UK National Screening Committee “ The public should be given a realistic view of the merits and flaws of screening so that they can make an informed choice and decline an invitation if they wish”. BMJ 14.10.2000 Why screen for breast cancer? • By far the most common cancer in women in the UK • In 2007 there were 2,457 new diagnoses of breast cancer and 637 deaths from breast cancer in Wales (all ages). • One in nine women will develop breast cancer at some time in their lives • Each year more than 41,700 women in the UK are diagnosed with breast cancer. • 80% of breast cancers occur in women over the age of 50yrs http://www.cancerscreening.nhs.uk/breastscreen/index.html What is breast screening? • Breast Screening is a way of checking for Breast Cancer • Screening can find those changes that you cannot see or feel • A breast X-ray or Mammogram is a good way of finding breast cancer http://www.cancerscreening.nhs.uk/breastscreen/index.html Mortality 18 16 14 Breast Bowel 12 Lung 10 Ovary 8 Stomach 6 Bladder NHL 4 Pancreas 2 0 Statistics from CRC All Wales Results 2007 - 2008 • Total Invited 129,767 • Total screened 94,448 • All Wales Uptake 72.8% • Uptake set out by Forrest Report 70% •Source: KC62, routine invitations, age 50 - 70 Who can go for breast screening? • All women who are registered with a GP, who reside in Wales and are aged between 50 -70 will be routinely invited to attend for breast screening • Invitations are sent out every three years • http://www.cancerscreening.nhs.uk/breast screen/index.html • mailto:info@cancer screening .nhs.uk What happens to women over 70? • Women who are over 70 are not excluded in any way • They will not be routinely called for breast screening • Therefore they will need to ring up Breast Test Wales and request an appointment Why women under 50 are not eligible for screening • Currently there is no research evidence to demonstrate that screening younger women reduces mortality rates • Women under 50 and those with breast symptoms are NOT screened by Breast Test Wales • Women concerned about a change in their breasts need to see their GP or Practice Nurse What if there is a Family History of Breast Cancer • Where there is a family history of breast cancer • The eligible woman may be referred by her GP to the local Genetic Service • They will then contact the woman to determine her level of risk http://www.breakthrough.org.uk/about_breast _cancer/family_history/index.html How are the women invited for breast screening? • All eligible women are sent are sent an invitation letter and leaflet inviting them to attend for their breast screening appointment Where women are screened • In most parts of Wales, women are invited to attend screening on a mobile unit Where women are screened • Women can contact • If they have breast Breast Test Wales if implants or have a • They wish to change disability, they will or cancel your need to be screened appointment at one of the static • If they have had a units mammogram in the • They can contact last six months. Breast Test Wales for more information The Mammogram • Breast is compressed between two plates. • This is quite firm in order to give better detail and clearer x-rays. • Four x-rays are taken in total. • Only performed by Top to bottom and side- female staff. to side view taken of • Takes just a few each breast minutes. What is a mammogram? http://www.goingfora.com/radiology/mammography.html What happen next? • Once the Mammogram has been taken the woman can get dressed How will I get my results? • Depending on screening area • Results are sent out within three weeks of screening. • 95% of women are given a normal result 5% are recalled. What do the results mean? • 95% of women will get a • 5% of women may be called normal result back for further investigation Recalled for further tests Llandudno If a woman is to be recalled she is only given 2-3 days notice to minimise anxiety. Wrexham Out of women who are recalled only 1 in 6 is given a diagnosis of cancer. What happens at this appointment • At the assessment clinic • Diagnosis follows review the woman will have a of assessment results by triple assessment specialist multidisciplinary • This consists of: teams comprising: • Imaging – further films • Radiologists are taken • Breast Surgeons • Clinical examination id • Pathologists given by one of the • Breast Care Nurses surgeons • Supported by Medical • Pathology Physicists and Radiographers Breast Test Wales • Breast Test Wales is a population based screening programme • It is responsible for screening well women only • If a woman requires treatment, this may be performed at any hospital, but is usually at a hospital where a BTW surgeon is based What do I need to tell the woman once she has been screened? All women need to be breast aware. The five point code is listed below: •Know what is normal for you • Look and feel • Know what changes to look out for • Report any changes without delay • Attend for breast screening if you are aged over 50 http://www.breastcancercare.org.uk How can you help? • Update your knowledge and skills regularly • Ensure you are giving the correct information • Have to hand appropriate resources – leaflets/ picture books/ fact sheets • If you are unsure of anything relating to breast screening - Contact us For Further Information…. • Contact: Heather Ramessur Screening Promotion Officer 01492 860888. • Write to us at: Maes Du Road, Llandudno LL30 1QZ • E-mail: • heather.ramessur-marsden@velindre- tr.wales.nhs.uk
"Practical Guide Assessment Tool"