GPAtlas🧭 When to offer screening
Breast screening is a preventative test for asymptomatic people, designed to find breast cancers when they are too small to see or feel – the stage at which treatment is simplest and most likely to succeed. Breast cancer is the most common cancer in the UK, where about 1 in 7 women are diagnosed in their lifetime.
The NHS Breast Screening Programme offers a two-view mammogram every 3 years to everyone registered with a GP as female, from age 50 up to their 71st birthday. The first invitation arrives between the ages of 50 and 53. For every 100 women screened, about 4 are recalled for further tests, and of those four roughly one is found to have cancer.
The key skill in primary care is twofold: promote informed uptake in the right group, and keep the screening and symptomatic pathways separate – anyone with a new symptom needs a symptomatic referral, not a screening appointment.
| Group | Screening offer |
|---|---|
| Under 50, average risk | Not routinely screened (mammographic sensitivity is lower in denser, younger breasts) |
| 50 to 71st birthday | Routine invitation every 3 years; first invite between 50 and 53 |
| 71 and over | Not automatically invited – can self-refer every 3 years via the local unit |
| Moderate / high familial risk | Enhanced surveillance from a younger age, via the family-history / genetics pathway |
| Very high risk (BRCA1/2, TP53, prior chest radiotherapy) | Annual MRI ± mammography surveillance from a younger age, per specialist protocol |
Source: NHS Breast Screening Programme · NICE NG12
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