Caroline Rubin
VP of Royal College of Radiologists
An invitation to a breast clinic for tests can be frightening. It doesn’t always mean you have cancer, but either way, here’s what to expect at your appointment.
Many of us fear an appointment at a breast clinic, whether we have been recalled after a routine breast screening or referred by a GP. Nevertheless, it’s important to go, and it helps to know what to expect.
A recall or referral does not automatically signify breast cancer.
“The majority of women attending breast clinics are not diagnosed with cancer. Most assessments reveal normal breast changes or benign conditions,” says Dr Caroline Rubin, Vice President for Clinical Radiology at The Royal College of Radiologists and practising breast radiologist at University Hospital Southampton.
Following routine breast screening (usually a mammogram, a breast X-ray carried out in a mobile van) most women get an ‘all clear’ letter. However, about one in 25 receives a recall letter, asking them to attend a specialist breast clinic. Only about a quarter of these women may have cancer.
Consider taking a friend
Other women attend breast clinics after being referred by their GP. Among these women the cancer diagnosis rate is 2% to 3%, as most of them turn out to be the ‘worried well’.
Following routine breast screening most women get an ‘all clear’ letter.
Consider telling a trusted friend or family member and taking someone (female or male) with you for support. “It’s encouraged, because the stress means that most patients do not remember the majority of what is said,” says Dr Rubin.
If you particularly want to see female staff, ask. The clinic will try to arrange it, though it is not always possible.
What to expect at the clinic
If you have been recalled following screening, you will have another mammogram, a breast examination and often an ultrasound scan too. Depending on what is observed, you may have a biopsy, in which a needle or small cutting device is inserted, usually under anaesthetic, to take a sample of breast cells or tissue to help with the diagnosis, using imaging techniques such as X-rays or ultrasound to ensure the biopsy targets exactly the right place.
Usually, all these procedures can be done on the same day at the clinic, and none of them mean that you inevitably have breast cancer.
If you have been referred by a GP, you will go to a one-stop clinic where you will be examined by a breast surgeon or clinician and have an ultrasound and/or a mammogram.
“Many women are referred because they have found a lump, which commonly shows up on the ultrasound image,” says Dr Rubin. “In many cases these prove to be not cancer, but fluid-filled sacs called cysts, which we can drain there and then.”
What you can expect your results
If the imaging and clinical examination are reassuring, the results are given immediately. If a sample is taken, you will be given an appointment to attend clinic about a week later to talk with a breast surgeon and (usually) a breast cancer nurse about your results.
“You get the results face-to-face even if you have not got cancer,” says Dr Rubin. “Your diagnosis will be explained and if any treatments are required, you will be able to discuss them.”
Dr Rubin adds: “Whatever the outcome, you will receive support throughout, so ensure you keep your breast clinic appointment. It could save your life.”
