The first time I remember checking my breasts was in my early 20s. I vividly remember scrolling through Tumblr and coming across one of those infographics that showed a young woman with her arm raised, her other hand placed on her nipple and, as the infographic suggested, checked for any lumps, swelling or skin dimpling.

While the infographic showed an image of a woman who looked quite calm about the whole thing, the first time I examined my breasts was marred with confusion. Was I doing it correctly? Was there something I missed? All those questions raced through my mind as I felt and fumbled around in an attempt to do the due diligence and self-check my breasts.

It’s in these moments of confusion that going to a see professional would be ideal. But whether it’s for a regular breast check or you’ve found something that could potentially be an issue, gaining access to GPs is now harder than ever – and for women under the age of 50, getting access to breast screening is nearly impossible.

According to the NHS, anyone registered with a GP as female will be invited for NHS breast screening every three years between the ages of 50 and 71. Trans and non-binary people may be invited automatically or you may need to talk to your GP or call the local breast screening service to ask for an appointment.

Upon finding out that women under 50 have limited access to breast screenings, I was in shock. After all, around 7,600 women in their 40s are diagnosed with breast cancer every year in the UK and a 2020 study by The Lancet Oncology found that screening mammograms at age 40 instead of age 50 saves women’s lives.

And while breast cancer diagnosis under 40 is rare (only 4% of breast cancer cases in the UK occur in women under 40) having access to these services is something that should be considered – but is it essential?

We spoke to three medical professionals about the issue to unpack whether women under 50 should have better access to breast screenings in the UK.

What are the current regulations when it comes to women getting breast screenings in the UK?

As it stands, women between the ages of 50 and 71 are invited to breast screenings every three years, while the NHS advises those younger to be “breast aware”, according to NHS GP specialist in women’s health Dr Hana Patel.

“It’s important to know what’s normal for you with regards to how your breasts look and feel and speak to your doctor about changes they notice straight away,” she says.

Why are women under 50 not advised to have regular breast screenings with a GP and are expected to rely on self-examinations?

While the idea of waiting until 50 to have regular breast screenings sounds daunting, there are a few key reasons behind this. “As most breast lumps in women under this age group are found to be normal, the chance of developing breast cancer increases with age,” says Dr Patel. 

“Also, the breast screening test used by the NHS is more suited to women after menopause in picking up cancer at an early stage as it is more common and more likely to get breast cancer the older a woman gets, especially after menopause,” she says. “The earlier cancer is picked up, it is more likely to be less aggressive and more likely to have a favourable prognosis.”

Addie Mitchell, a nurse specialist for Breast Cancer Now adds that younger women also have “denser breast tissue”, which can make the x-ray image less clear and changes harder to identify.

“However, a small number of breast cancers are genetic and if your family history of breast cancer is significant, you may be eligible for more frequent screening or genetic testing,” she says.

Should women under 50 should have better access to breast screenings in the UK?

For junior doctor Rumbi Mutenga, having better access to screenings for women under 50 is reflective of a wider issue of inaccessibility when trying to get GP appointments as a whole.

“I had the privilege of interviewing Hatti Gayner, an avid breast cancer campaigner, before her passing,” says Mutenga. “Hatti was diagnosed with advanced breast cancer in her 20s. Although Hatti’s case was uncommon, it highlights the importance of access to GP appointments. At present many people are complaining about the ability to see a GP and anyone with symptoms should be able to see a GP face to face promptly for a review and examination.”

While having better access would be ideal, key changes would be needed to facilitate this, adds Dr Patel. “There would need to be better resources, clinicians to see patients and then the infrastructure and team to see patients if there are concerns and need for further investigations,” she says.

“Ultimately, women can make an appointment with their doctor to share their concerns about any symptoms they have, but the breast screening programme is more specifically for women after menopause,” says Patel. “Perhaps different tests could help for women less than 50 years old to be more specific to detect early cancer but at the current stage, self-examination is key.”

Is there a correct way to self-examine your breasts?

Mitchell says when it comes to breast checking, doing it regularly and knowing what’s normal for you is key – that way you can report anything new or different.

“It’s as simple as TLC: touch, look, check,” she says.

“Checking your breasts only takes a few minutes, and we suggest that everyone does this regularly. It could be when you get dressed when you’re showering or putting on moisturiser. It’s important to remember to check your whole breast area, your armpits and up to your collarbone (upper chest) for changes.”

While better access to these screenings for women under 50 would be ideal, the current infrastructure doesn’t allow for that to be a reality.

In a bid to take care of ourselves and our bodies the most, self-examination and being aware are key.

Image: Getty