A mammogram every three years from 50, and self-referral after 70. The one screening programme where the trade-off is genuinely debated.
NHS screening is free — this page explains it, we do not sell it
Honest about who benefits and who may be harmed
A GP to talk through a result, a recall or a missed invitation
Your NHS records in the room, with your consent
Talk it through with a GP
Screening itself is free on the NHS. If you want a result explained, have been recalled, or missed an invitation and are not sure what to do, a 20-minute appointment with a GMC-registered GP is £40. Same-day appointments are usually available, 6am to 10pm, seven days a week.
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Women and people with breasts registered as female with a GP are invited automatically, starting between the ages of 50 and 53 and continuing every three years until around 70.
The first invitation can arrive any time up to your 53rd birthday, because invitations are organised by GP practice rather than by individual birthday. If you turned 50 last year and have heard nothing, that is usually normal rather than an error.
Routine invitations stop, but you remain entitled to screening every three years and can arrange it yourself. Contact your local breast screening unit.
Breast cancer risk continues to rise with age, and this is one of the more commonly missed entitlements.
A strong family history, a known BRCA1, BRCA2 or other high-risk gene, or previous radiotherapy to the chest put you into enhanced surveillance — starting younger, more often, and often with MRI rather than mammography alone.
That is arranged through a genetics or breast service, not through the routine programme. If breast or ovarian cancer runs in your family, raise it rather than waiting to turn 50.
Invitations are generated from the gender registered with your GP, which means people are routinely missed.
You can ask your GP or the local screening unit to arrange it directly. This is worth doing rather than assuming the system has you.
It takes about fifteen minutes in total, and the imaging itself takes a couple of minutes. Often in a mobile unit in a car park or at a local clinic.
The compression is the part people dread and the part that makes it work, because it spreads the tissue and lowers the radiation dose needed.
A letter within about two weeks.
An assessment clinic, usually within two weeks, with more detailed mammogram views, an ultrasound, and a needle biopsy if anything needs sampling.
Recall is much commoner at a first mammogram, because there is nothing to compare against. That is worth knowing before the letter arrives.
Breast cancer is the commonest cancer in UK women, and screening finds it earlier than symptoms do.
The programme is estimated to prevent a meaningful number of breast cancer deaths in the UK each year.
That is the genuine benefit. The section below on harms is equally genuine, and we would rather you had both than a page that only gives one.
Breast screening is the programme where the benefit-to-harm balance has been most debated among clinicians and researchers, and any honest page has to say so.
The Marmot review, commissioned to settle the question, concluded that the programme confers significant benefit and should continue — while confirming that overdiagnosis is real and not small.
Its central estimates, expressed per 10,000 women invited from 50 and followed for 20 years:
That works out at roughly three women overdiagnosed for every death prevented. Those are the actual numbers, and they are why reasonable people reach different decisions about attending.
Some cancers grow so slowly, or not at all, that they would never have troubled the woman in her lifetime. There is currently no reliable way to tell those apart from dangerous ones, so all of them are treated.
That means surgery, and often radiotherapy or hormone treatment, for a disease that was never going to cause harm. It is the single most important thing to understand about breast screening, and it is frequently glossed over.
The NHS position, and ours, is that the benefit outweighs the harm for most women — but that it is a genuine choice, not an obligation. The NHS provides a leaflet setting the numbers out, and it is worth actually reading.
Reviewed against the independent UK Panel review of breast screening, UK National Screening Committee and NHS Breast Screening Programme guidance current at the date shown above.
Around seven in ten invited women attend, which is below the programme's target and has drifted downwards.
Screening units can offer longer appointments, a familiarisation visit, or a quieter time of day. Ask — these adjustments exist and are underused.
Ring your local breast screening unit and ask. You can be screened every three years; you simply will not be invited.
This matters more than anything else here. Screening is for women without symptoms. A symptom needs assessment now.
A normal mammogram last year does not exclude a cancer that has appeared since. Cancers arising between rounds are well recognised, and a past clear result is a common reason women delay.
Breast awareness matters between screens — not a formal monthly routine, simply knowing what is normal for you and acting on change.
Around 129 women per 10,000 invited are treated for a cancer that would never have harmed them. There is no test that identifies which ones, so all are treated.
This is the real cost of the programme, and it is not small.
Around 4 in 100 women are recalled, and most turn out to have nothing wrong. The intervening weeks are genuinely distressing, and some women undergo a biopsy unnecessarily.
The dose is very low, and the risk of screening itself causing a cancer is small and far outweighed by the benefit in the invited age group. It is a real consideration rather than a serious one.
It looks at the breasts and nothing else. It says nothing about ovarian cancer, which is not screened for in the UK and which shares a genetic link with breast cancer through BRCA.
Attending is a choice, and declining is a legitimate one. The NHS leaflet sets out the numbers, and we are happy to go through them with you if the decision feels difficult — which for some women it genuinely is.
It is uncomfortable, and for some women briefly painful. The compression lasts seconds.
Booking mid-cycle rather than just before a period helps, and taking paracetamol an hour beforehand is reasonable. Tell the mammographer if it is very painful — they can adjust.
No. You remain entitled to screening every three years, you just have to arrange it yourself.
Contact your local breast screening unit and ask. Risk keeps rising with age.
Most likely not. Around 4 in 100 women are recalled and roughly three in four of those are given the all-clear.
Recall is much commoner at a first mammogram, simply because there is no previous image to compare with.
It means being treated for a cancer that would never have caused symptoms or shortened your life. Around three women are overdiagnosed for every death the programme prevents.
Most women still judge the trade-off worth it, but it is a real choice and you are entitled to the numbers before making it.
Because breast cancer is less common before then, and mammograms work less well on the denser breast tissue of younger women.
Below 50 the harms outweigh the benefits for the general population — which is different for women at high genetic or family risk, who are screened earlier.
Possibly, and it is worth raising now rather than at 50. A strong family history can qualify you for earlier and more frequent screening, sometimes with MRI.
Ask about referral to a family history or genetics clinic.
No — get it checked now. Mammograms miss some cancers, and new ones appear between rounds.
A previous clear result is one of the commonest reasons women delay, and it should never override a new symptom.
The dose is very low. Any risk from the X-rays themselves is small and heavily outweighed by the benefit in the screened age group.
It is a real factor rather than a serious one, and it is part of why screening is not offered to younger women routinely.
Generally yes if you have taken feminising hormones for several years — but you may not be invited if you are registered as male with your GP.
Ask your GP or the local screening unit to arrange it, rather than assuming the system will find you.
There is no clinical advantage to paying for the same test the NHS provides free in the eligible age group.
Private imaging is worth considering if you are outside the programme and have a specific concern — but a symptom should go down the NHS urgent referral route, which is faster.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
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