Analysis: More to diagnosis than screening

HAVING a mammogram is not the most pleasant of procedures. It’s uncomfortable and can be painful. In fact, I am sure more women would attend if there was a less uncomfortable examination.

Then there’s the waiting for the results, worrying until you get the all-clear. And every woman who goes for a mammogram is in no doubt. They are looking for one thing – cancer.

Some, like me, do not attend for all of the three-year checks on offer. As a medical professional I know how to self-examine. That is a personal choice. I hope that I will notice if something needs investigation, but nothing is 100 per cent.

Perhaps some women are willing to attend for routine screening for mammograms, but forget to be breast aware between their three-yearly checks, and that’s a pity.

I believe there are possibly some very significant changes to the screening system in the years ahead that may leave women with a dilemma. Traditionally, there has always been the assumption that this is what we must do. Now we may see some changes creeping in.

It’s very confusing for women when even the experts can’t agree. So women may find themselves wondering about whether to go for screening.

I do believe in informed consent. I believe people are not incapable of understanding information when they are given it in plain language. Doctors can underestimate people, but when presented with the facts, patients can make informed choices.

The crucial thing is that mammograms can and do save lives. Anything that saves lives from cancer is to be encouraged. However they do not give a definitive diagnosis of the problem and their benefits can be overplayed.

But the screening test itself is not the issue. The important thing is what we do with the information and how we deal with women who do have difficult decisions to make.

I welcome patents having more information in leaflets and being encouraged to self-examine more frequently, backed with more input from health professionals; although this would need more time set aside.

So if a woman does decide to go for an operation, which could result in her breast being removed, she must only do so only with all the information at her disposal, so that she has made a truly informed choice.

There is more than routine mammography to the diagnosing of breast cancer. I think what angers me most is when the Scotland Patients Association hears of the occasional woman who has had difficulty in obtaining an urgent referral to a specialist breast clinic by their GP.

Once a woman is aware of a change, she is thinking of cancer until proved otherwise. The longer the wait the worry mounts, as every second that ticks past counts to having that important diagnosis, and the most appropriate treatment.

And that’s why it’s important that we continue to look at all aspects of breast cancer care for the health of all women in the fight against this disease.

• Dr Jean Turner is executive director of the Scotland Patients Association