Download the file - General Practice

Non participation of Screening Coordinator Script
[Check talking to right patient]
I am calling On Behalf of Dr … at … Practice.
We understand that you haven’t attended your screening appointment. Is that correct?
[If yes, proceed. If no, thanks them for their time and end the call].
You are at increased risk as most people who get Breast Cancer are over 50
Do you need the telephone number for the Breast clinic? 01273 664966
If asked, read the following facts:
Breast- Brief explanation of breast cancer
Your doctor/the practice is very supportive of breast screening and we are encouraging all our patients
over the age of 50 to take part in screening
Breast cancer is the most common cancer for females in the UK
The majority of breast cancers (81%) occur in women over 50.
Breast cancer starts when cells in the breast begin to divide and grow in an abnormal way. It’s caused
by a combination of lots of different factors, many of which are beyond our control
The good news is that breast cancer is very treatable if found early. More than 80% of women survive
breast cancer beyond five years. Around 78% of women survive beyond 10 years.
Men get breast cancer too, although it’s very rare. Of the 60,000 people diagnosed each year with
breast cancer, about 340 are men.
Breast screening
Breast screening is an x-ray examination of the breasts, known as a mammogram. It may help detect
breast cancer before there are any signs or symptoms. The sooner breast cancer is diagnosed the
more effective treatment may be.
Because breast cancer is more common in women who are over the age of 50, women aged 50 to 70
are invited for routine breast screening every three years.
The age range for the screening programme is being extended to 47-73 as part of a trial which will
include all women by the end of 2016 in England.
Going for breast screening will not prevent breast cancer from developing, but it may find a breast
cancer sooner – before it can be seen or felt.
If the patient remains uncertain about the process, invite them to the practice for a face to face
discussion.
Transgender information
If you are an FtM (female to male) /trans man aged 50 to 70 who is registered with a GP as male,
you will not be invited for breast screening. If you have not had chest reconstruction (top surgery) we
suggest that you talk to your GP to arrange a referral to your local breast screening centre to have a
mammogram. If you have had chest reconstruction (top surgery) and you still have breast tissue, you
will need to talk to your GP to arrange for a referral to your local breast screening centre.
 If you have been on long-term hormone therapy you may be at increased risk of developing
breast cancer and should go for screening when invited.
If you are an MtF (male to female) /trans woman aged 50 to 70 who is registered with a GP as
female, you will be invited for screening. Long-term hormone therapy can increase your risk of
developing breast cancer so it is important that you go for breast screening when you are invited.
If you are an MtF/trans woman aged 50 to 70 who is registered with a GP as male, you will
not be invited for breast screening so you should make an appointment if you are using hormones
and have breast tissue. If you register as female with your GP, you will be routinely invited for
breast screening.
Provide the opportunity to ask questions and remind them that they can make an appointment to see
their doctor if they are worried about any symptoms that might be breast cancer.
See your doctor straight away if you have any symptoms that might be bowel cancer
 a lump in the breast.
 a change in the size or shape of the breast.
 dimpling of the skin or thickening in the breast tissue.
 a nipple that's turned in (inverted)
 a rash (like eczema) on the nipple.
 discharge from the nipple.
 swelling or a lump in the armpit.
Other questions:
1. Why is it so important to spot breast cancer early?
Cancer that’s diagnosed at an early stage, before it’s had the chance to get too big or spread is more
likely to be treated successfully. If the cancer has spread, treatment becomes more difficult, and
generally a person’s chances of surviving are much lower.
2. Why should I be screened for breast cancer?
Screening can pick up lumps that are too small to see or feel. Early detection vastly improves survival
rates.
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3. Can I reduce my chances of getting breast cancer?
Yes. Breast cancer is a very common type of cancer and over half of cases are caused by risks that
you can control including:
Limit alcohol. The more alcohol you drink, the greater your risk of developing breast cancer.
Don't smoke.
Low intake of saturated fat and alcohol
Maintain a healthy weight
Be physically active
Breast-feed
Limit dose and duration of hormone therapy
Avoid exposure to radiation and environmental pollution
4. My parent/sibling had breast cancer. What should I do?
A small number of people have a higher risk of developing breast cancer than the general population
because other members of their family have had particular cancers. This is called a family history of
cancer. It relates to past and present cancers of blood relatives (people related by birth, not marriage).
This increased risk may be due to an inherited faulty gene.
Having a mother, sister or daughter diagnosed with breast cancer approximately doubles the risk of
breast cancer. But more than 8 out of 10 women who have a close relative with breast cancer will
never develop it.
Reasons for not doing the screening
1) Why do I need to be screened? I have no symptoms or family history.
Screening saves lives, the earlier the problem is detected, the more likely people are to lead long and
healthy lives. Anyone can get breast cancer and screening can prevent it developing and save your
life.
2) I have already been screened
(i) if recently, ask if they have any other questions, thank them and terminate the call.
(ii) if under 50, and they say that they had the test some time ago, inform person that they wouldn’t
have been asked to do a screening test before they were 50 in this country. It may have been a
diagnostic test, or have been offered in another country. If so, it’s a good idea to join the screening
programme now.
3) It’s far too uncomfortable and painful:
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.
4) My friend did it and he/she had a bad experience: find out what the experience was, address
accordingly emphasizing that most people rarely have such experiences.