 Hi everyone and welcome back to another vlog. My name is Claire Carmichael, I'm a general practice nurse and today we're gonna be talking about something really important, which is breast screening. And actually I had a really lovely email from someone who had seen the previous cervical screening vlog and thought this would be a really good topic to bring up and they were absolutely right. I'm not gonna name the person because they wanna keep anonymous, but I love you, thank you so much and I hope I can do this vlog justice for you. So firstly, what is breast screening? So breast screening is a type of screening through an x-ray called mammogram of the breasts and anyone registered with a GP as female, we'll go on to that topic later, will be invited for an NHS screening every three years between the ages of 50 and 71. And mammograms look for any signs of cancer that might be developing in the breast tissue and you don't have to have symptoms or anything like that to go for your breast screening because the idea is the screening healthy people that don't have any symptoms or anything like that and picking up things that they might not have noticed just to reduce their chances of it spreading or developing into cancer and getting a lot worse. So it's caught sooner. And the treatment would ideally be better as a result if it's caught earlier, it's treated faster and hopefully it's not gonna cause too many issues for somebody, but I know it can be quite scary and it's not always the best result for some people which is really sad. And also, like everything in life, nothing is 100% accurate. So things can be missed and it's not gonna prevent you from getting cancer as well. You still can develop cancer, but it's just that test that can hopefully stop it and prevent and catch it before it's too late. And just some stats for you. The breast cancer screening finds cancer in around nine out of a thousand people. And if you are over 70 years of age, you can still have your breast screening done. You just have to request it and you can do this every three years. You just won't be invited for it, that's all. And if you're younger than 50, the research shows that breast cancer is quite low if you're under 50, but that doesn't mean that you can't get it. So it's really important that if you notice any changes in the breasts, in the chest area, under your armpits, any of that sort of area, it goes all the way from here, all the way down through to your armpits. Any changes to your skin, any abnormalities, anything you notice, please see your GP and just get it checked out. But not only is the risk lower in people under 50, actually mammograms are a little bit inaccurate as well because the breast tissue's a lot denser and things like that. So it's quite hard to read a mammogram and that's where I think confusion comes in and complications. So they just don't do it into your 50. But like I said, if you have any problems, you notice any changes, please get it checked because it's always better to be safe than sorry. And to be honest, I was this person, I was about 21 I think and I had to go to my GP because I felt some lumps in my breast and the doctor checked it all out for me. Luckily it was just hormonal changes and it was just like fatty tissue and stuff like that that I was feeling. So it was nothing to worry about thankfully. But yeah, if you notice anything, just go and get it checked because it is far better and it's gonna put your mind at ease as well just to get it checked. But I know that this can be quite a triggering thing for some people in some situations. And the reason why this is very important is because breast cancer is the most common cancer in the country. One in eight people will get breast cancer. However, because of amazing treatments, amazing technology, more people survive breast cancer than they did back in the day. So just some pros and cons of breast screening. So the good stuff is it can pick up cancer, it can save lives. That's always the message that we see and it can help sort of detect things that might be too small to feel as well in the breast tissue and things like that. So it's a really good way of assessing and yeah, diagnosing and treating. The cons of breast screening is if something is found and they're not sure what it is, you might need some extra tests that might not have been needed in a way because there's all sorts of things that it can be. It's not just cancer. You could have cysts and benign tumors and things like that that aren't harmful but they're just there. So people go and have biopsies and things like that. And it's a lot of tests and I think a lot of anxiety for some people and I think that's the downside to having this sort of thing. But like I said, I think for me personally, I would rather have the extra tests and make sure it's okay than not. And another sort of con, I suppose, like I said, it's not 100% accurate. So on the rare chances that they might miss something that's not picked up and then you develop breast cancer anyway, which is, it's not, yeah, it's not nice. And cons, cons, cons, I've got more cons. I'm so sorry guys about breast screening. So I just wanna touch up on things like trauma. If someone has been through some form of trauma in the past, assaults for example, sexual abuse, all sorts of different things. They might have had a previous scare of cancer and that's bringing back some horrible memories and they don't wanna go for the screening because it's just triggering a lot of different emotions and different responses, which must be, I can't even imagine how that must feel for someone. And I think we need to deal with it better as healthcare professions and we need a lot more awareness and a lot more training on that topic in itself because we need to be supporting patients like this to make the best decisions and allow them to opt out if they don't want the screening, allow them to opt out instead of making them feel guilty for not doing it. At the end of the day, it's patients choice as long as they've been given all of the information, then they have the right to that. And you know, when you see posts on social media and stuff like that and people are sharing things like, oh, have your breast screening, it can save your life. People aren't thinking, do you know what? If only it was that easy for some people, if only people would just say, yeah, okay, I'm gonna go for my breast screening, but actually it's not that easy for some people and we need to raise the awareness and this is why I wanted to do this video as well, just like the cervical screening or cervical screening because I say it wrong, sorry guys, but it just needs more awareness that actually some people have been through a lot, they don't wanna disclose that, they might not wanna speak to you, they might not feel comfortable disclosing that, so just whatever their reasons, just respect it and allow people to opt out. And if someone does feel comfortable enough to disclose something like that to you, make sure you support them, make sure you're ready for that conversation, make sure there's things in place to help this person, make a decision and go through with it if they need it. And the next con I'm gonna talk about, transgender healthcare, because you know I'm all passionate about that as well, those of you that watch them and follow my vlogs. This is a massive barrier, but it's also a massive area that gets missed if someone is now registered as a transgender male, they're not gonna be invited for their screening because they're down on the system as male, exactly the same with cervical screening, they're not gonna get that invitation letter anymore, so I think something needs to be in place, maybe there is something in place, maybe I'm just missing something, but when I've looked and when I've researched, I can't see anything. So there needs to be something in place that triggers the NHS that says, okay, this person is actually transgender, this person needs to still be offered the screening if they want it. And then on the other hand, again, people will not feel comfortable sharing their bodies and transgender people have this constant battle with their own bodies. I mean, I'm not transgender, but I've gone out and I've done my research, I've spoken to transgender people, I've got more awareness around how they feel and what they have to go through on a daily basis from the day that they wake up to the minute that they go to bed. So imagine being so uncomfortable in your body and then having to expose yourself to a healthcare professional or a stranger that they don't know, they don't feel comfortable with, it's gonna trigger a lot of responses and it's really, really important that again, we have the support, we have that understanding, we have that respect for these people and because we're missing a massive group in healthcare, I'm not gonna go on events today about transgender healthcare. I seem to go on an event about it, I'm sorry, I'm just really passionate about it and I'm really passionate about helping those people and helping people that have been through trauma as well. More awareness is needed, again, more training is needed in transgender people and how we can tackle these barriers to provide a better service for people. But again, if someone wants to opt out, let them opt out, document it and respect their wishes without trying to force someone to do something they don't want to do. And it's not just transgender people, it's the whole LGBTQ plus community in itself and Stonewall produced some research that they did on whether lesbian and bisexual people in particular were checking their breasts and only 30% said that they would check their breasts every month and 50% said that they would check their breasts every few months. So I just feel that there's a few gaps in our healthcare system around this community in particular and it's something that hopefully we can change and tackle and talk about more and I hope that this video just helps raise awareness of those really important issues as well. And like I said, not just this, but the trauma-informed care as well with our patients. We need to do something about this and hopefully we can make change together. So how is a mammogram done? So mammograms from what I've gathered so far, I mean, I've never had one, but just doing my own research and things like that. They're normally set as a dedicated breast screening unit with the machine set up. Sometimes you might see them at places like supermarkets and things like that. There'll be a big breast screening NHS fan where you can go to and it travels around just to help people get access to these services because I think people struggle to get access. So they thought of this innovative way to sort of get out there and see people. The patient will then, when they go into the unit, they'll fill out some forms, hand over their information, name date by birth, that sort of thing, all the standard stuff, and then they'll be asked to undress from the waist up to take away any top ready for the mammogram to happen. Then the person doing the test, the mammographer, I hope I've said that right, it will always be a female and they will do all of the tests. And then what happens then is you're asked to put your breast in between like two glass sheets. So your breast will be squashed like this. Me, I don't have much, so I'm not too sure how mine's gonna go. I don't know. But it gets laid on some glass and then they press the breast against the glass so that they can take some images of the breast tissue and everything inside. And to be honest, from what I've heard from people, it's very uncomfortable. It's not a pleasant experience and a little bit painful as well if you've got quite sensitive breast areas. And then the breast's only pressed for a couple of seconds just while they take a couple of images. And then your results will come in the letter in the post within two weeks. And lastly, I just wanted to talk about how to check your breasts. This is something I was never really trained to do, but I had an amazing session with Coppa Feel who do sort of webinars and stuff like that on how to look and feel for any abnormal changes. Their website's fabulous. I'm gonna put some links below for you to have a look at. It's a really, really good website and it's stuff that I use every day now when I'm doing my cervical screening, for example, and I'm talking about breast examinations and things like that. So it's really, really useful to look at. Yes, the main thing is touch, look, check. So you can touch your skin. Is there anything abnormal? Does it feel smooth? Has it changed in texture in any way from when you previously checked? And if you check regularly as well, you'll know what's normal for you. And that's the main thing. You know how your skin feels. You know how it looks. And if you notice anything that's not right or any changes, that's when you go to see your doctor. And the main things you're looking for is one, the obvious one is a lump. That's what everyone thinks about when they think about breast examination, but actually the change in the skin, if it's going like an orange peel type of hardening, that pimpled sort of skin, that's sometimes an indicator. A change in appearance of your nipples or a change of direction of your nipples. Any abnormal discharge or liquid that's coming out of your nipples. Any redness or rashes on the skin around your nipples and on the breast area. So I hope this vlog has been really useful and helpful in understanding breast screening, a bit about why we do it, some of the stats as well, and some of the barriers to breast screening, which was the most important thing that I wanted to talk about in this vlog. I hope that it's raised some questions for you and got you all thinking about these things. But my main advice is do your research, have a look into it, look at the barriers and just be as respectful and kind and help people where you can. So I'm gonna say goodbye from now. If you have anything that you wanna request, if you have any questions, if you have anything, any comments, whatever, put a comment below, I will get back to you ASAP. And if there's any other videos that I can do, please request them because I will always do really interesting videos like this one, so please request them and I shall try my best. Have a great day, everyone. Thank you.