Susan Leeson, 56, thought her clear mammogram meant she was safe from breast cancer for the next three years. However, she was diagnosed with incurable cancer that had spread throughout her body, highlighting the limitations of mammograms in detecting breast cancer.
Susan Leeson thought her clear mammogram meant she could briefly relax about her risk of breast cancer until her next routine screening in three years' time.Susan, 56, who is married to a corporate lawyer and has a teenage daughter, now desperately wishes she hadn't put so much faith in the result. For seven months later, and only after going to A&E with agonising back pain, Susan discovered she had a fractured spine.
Had her cancer been spotted on the mammogram, she says: 'The chances are that I would have had a little operation and be getting on with life.' Women are offered a mammogram – two X-rays of the top and two of the side of each breast – every three years, starting from when they are aged 50 to 53 and extending until 70.Almost 20,000 cancers were detected in the 2.18 million women in England who had a routine mammogram in 2022-2023.
Indeed, mammograms can detect not just tiny cancers, but also tiny specks of calcium, known as calcifications, which can be benign but may also be a 'sign of pre-cancerous changes in the breast,' says Caroline Rubin, a consultant radiologist specialising in breast imaging at University Hospital Southampton.
'A significant number' of breast cancers missed on mammogram are due to the breast density, adds Professor Kefah Mokbel, a consultant breast surgeon at the London Breast Institute, who has been involved in research into new types of screening. The NHS does not even routinely let women know even if a mammogram reveals they have dense breasts – which he argues is wrong 'as not only do the dense breasts make it harder to spot any tumour, they can also increase the risk of cancer'.'In some states in the US, it is illegal not to inform a woman if a mammogram shows she has dense breasts,' says Professor Mokbel.
The surgery would immediately bring on the menopause and it was suggested she have HRT implants, placed under the skin during the operation, to avoid being thrown straight into menopause while recovering from major surgery. 'The first thing my oncologist said is that the HRT had accelerated the cancer. It might have been sitting there for years not growing much – since I was diagnosed, it hasn't grown – but the HRT was like pouring fuel on the fire.'
And as Susan points out, there is no extra guidance about analysing the mammograms of women with dense breasts – 'even though it's acknowledged that they make it harder to spot cancer'. A spokesperson told Good Health: 'The vast majority of units are within the acceptable level and rates are regularly reviewed within screening units as well as by commissioning and quality assurance teams.'
A spokesperson for St George's University Hospitals NHS Foundation Trust said: 'We understand how distressing this diagnosis must be for Mrs Leeson and her family, and are very sorry her cancer was not picked up at screening and that she is unhappy with her care. This may help those interval cancers caused by fast-growing cancers – which grow in between screenings.
Advances are under way. The NHS has started using 3D mammography, or tomosynthesis, during which the X-ray moves around the breast, taking images at different angles, providing a more detailed 3D image of the breast.Another study, being carried out at multiple sites across England, is looking at 'fast MRI', which takes fewer images – and so takes three minutes, not 20 minutes as traditional MRIs do.
Breast Cancer Mammogram Health Screening Cancer Detection Medical Misdiagnosis
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