📷 NHS & WHO sourced

Mammogram and NHS Breast Screening — What to Expect

What is a mammogram, does it hurt, and what do your results mean? Who the NHS invites for free breast screening, when, and how to self-refer if you are over 71.

Reviewed against NHS & WHO guidelines Last reviewed: January 2025 For educational purposes — not medical advice
✓ NHS invites women aged 50–71 every three years for free mammography
✓ Women over 71 can self-refer for screening
✓ Around 5% of women are recalled after screening — most recalls are not cancer
✓ Early detection via screening significantly reduces breast cancer deaths

Who is invited and when

As part of the NHS Breast Screening Programme, all women in England aged 50–71 registered with a GP are automatically invited for a mammogram every three years. In some areas the programme invites women from age 47 as part of an age-extension trial. Women over 71 are no longer automatically invited but can self-refer for screening by contacting their local screening unit.

Some women are offered more frequent screening or different imaging (such as MRI) due to higher risk — for example, those with a strong family history or known BRCA gene mutations. Your GP can refer you for a high-risk assessment if appropriate.

What happens at the appointment

A mammogram appointment usually takes around 30 minutes. A female radiographer carries out the mammogram — two X-ray images are taken of each breast by compressing the breast between two plates. The compression lasts only a few seconds and while it can be uncomfortable, it is not harmful. The images are sent to a radiologist for analysis.

Understanding your results

  • Normal: No abnormalities found. You will be invited again in three years.
  • Recall for assessment: A small number of women (~5%) are recalled for further tests (additional imaging, ultrasound or biopsy). This does not mean cancer is present — the majority of recalls are not cancer.
  • Cancer detected: Treatment planning begins promptly. Early detection dramatically improves outcomes.

Limitations of screening

Mammography is not perfect. It can miss some cancers (false negatives) and can flag abnormalities that turn out not to be cancer (false positives). Dense breast tissue makes mammograms harder to read. This is why regular self-checking between appointments remains important — if you notice any change, see your GP regardless of when you last had a mammogram.

Screening in low-income countries

In the UK, routine mammography has contributed to a significant reduction in breast cancer deaths since 1988. In low-income countries where Breast Cancer Awareness works, no equivalent programme exists. Most women in South and South-East Asia have never had a breast examination. This is why we fund mobile screening units and community health educators — to bring basic screening to women who would otherwise never receive it.

Frequently asked questions

What is a mammogram? +
A mammogram is an X-ray of the breast used to look for early signs of breast cancer, including tumours too small to feel. During the procedure, each breast is placed between two flat plates and briefly compressed while the X-ray is taken. NHS mammograms are free for women aged 50–71, take around 30 minutes, and each image is read independently by two specialist radiologists.
Does a mammogram hurt? +
A mammogram can be uncomfortable, particularly around the time of your period when breasts may be more tender. The breast is compressed between two plates for a few seconds to capture a clear image. Most women describe it as briefly uncomfortable rather than painful. If you find it painful, tell the radiographer — they can adjust the technique. The brief discomfort is far outweighed by the benefit of early detection.
What age does NHS breast screening start? +
The NHS invites all women aged 50–71 registered with a GP for a free mammogram every three years. In some areas, the programme invites women from age 47 as part of an age-extension trial. Women over 71 can self-refer for free screening by contacting their local breast screening unit.
What is dense breast tissue and does it affect screening? +
Dense breast tissue means the breasts contain more fibrous and glandular tissue than fatty tissue. Around 40% of women have dense breasts. On a mammogram, dense tissue appears white — the same colour as potential tumours — which can make cancers harder to spot. Women with very dense breasts may be offered additional screening such as ultrasound or MRI in some areas.
What if I am recalled after mammography? +
Around 5% of women are recalled after screening for further assessment. Being recalled does not mean you have cancer — the majority of recalls do not result in a cancer diagnosis. You will receive additional imaging (further mammogram or ultrasound) and possibly a biopsy to clarify the finding.
Can women under 50 get a mammogram on the NHS? +
Routine screening is not offered to women under 50 in the UK. However, women at high risk due to a strong family history or known BRCA gene mutation are offered earlier and more frequent screening — often annual MRI from age 30. If you are concerned about your risk, speak to your GP about a referral for a family history assessment.
What age should women start mammogram screening? +
Recommendations vary by country. In the UK, the NHS invites women aged 50–71 every three years. In the US, the American Cancer Society recommends annual mammograms from age 45, and the USPSTF updated its guidelines in 2024 to recommend screening every two years starting at age 40. Women at higher risk due to BRCA mutations or strong family history are offered earlier screening in both countries, typically from age 30.

Clinical sources

  • NHS — www.nhs.uk/conditions/breast-screening-mammogram
  • World Health Organization — www.who.int

This content is for educational purposes and does not constitute medical advice. Always consult a qualified healthcare professional for personal medical guidance.

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