Benefits of the population screening

If you participate, you are less likely to die of breast cancer.

• Of every 1,000 women aged 50 years, 40 die of breast cancer in the course of their lives. Women who take part in the population screening are 50% less likely to die from breast cancer than women who do not participate.
• For women who are slightly older (between 70 and 75 years) and who participated more often, the effect of breast cancer screening appears to be greater. In this group, the reduction in mortality is about 80%. For slightly younger women (between 50 and 69 years), this percentage is lower, namely about 40%.

If you participate, physicians can detect breast cancer sooner. You are more likely to be cured.

• Population screening allows physicians to detect and treat breast cancer earlier. Even before you develop any symptoms or can feel or see the breast cancer yourself. This reduces the risk of metastasis and may reduce the burden of treatment. Early detection increases your chances of being cured.
• Every year, the population screening detects a tumour in about 7,000 people The population screening reduces the number of women's deaths from breast cancer by 1,300.

Disadvantages of population screening

If you participate, you may get referred for further assessment unnecessarily.

• Sometimes, X-rays of your breast show an abnormality. In that case, further examination in the hospital is needed to see what is going on. Sometimes it turns out afterwards that nothing is wrong. In that case, further examination was not needed. This happens every year to 17 of the 1,000 people who participate in the population screening.
• If it turns out, after further examination, that you do not have breast cancer, this may have caused you unnecessary anxiety and stress. But you would probably also be relieved.
• In the population screening, we would prefer to refer only those people who actually have breast cancer. Unfortunately, this is not possible, no matter how closely we examine people and no matter how good the techniques are.

Treatment may not have been necessary.

• Physicians will almost always treat breast cancer. Sometimes a tumour grows so slowly that it will not cause problems during a person’s lifetime. In that case, treatment was not really necessary. This happens in about 1 in 10 people with breast cancer. We cannot determine beforehand who does not need treatment.

Early detection does not always mean living longer.

• The early detection of breast cancer does not always make people live longer. When someone finds out early that they have cancer, this produces longer-term mental strain from visits to the hospital for treatment and follow-up. We never know in advance if someone actually lives longer.

The population screening can unjustifiably reassure you.

• The screening test does not provide complete certainty. Sometimes someone does have breast cancer, even though physicians did not see it in the population screening. 2 to 3 in 10 cases of breast cancer are not detected by population screening.

Population screening is a snapshot in time.

• The screening test is a snapshot in time. The radiologists examine the breasts at a certain point in time. At that time, they may not detect breast cancer. But that does not mean that breast cancer cannot develop. In about 2 in 1,000 subjects studied, physicians detect breast cancer at some point in the 2 years between population screening tests.

The examination can be painful.

• To get a good picture, with as little radiation as possible, your breasts are compressed between 2 plates. That can be painful. At the moment, X-rays are the best and fastest way to detect breast cancer in population screening.

Points of attention when deciding to participate

If you have had a medical chest device implant, breast implant, bypass or other breast surgery in the past six months:

• In the case of a medical device implant (e.g. pacemaker) and breast surgery, you can participate in the population screening 6 months after placement/surgery. This period is chosen because the site may still be sensitive.
• In the case of a breast implant or a bypass, it is recommended that you wait 6 months before participating in the breast cancer screening. This is a very strong recommendation, but not mandatory.

If you are being treated for your breast(s).

• You do not have to participate in the population screening if you have any issues with your breasts and are being treated by a specialist.
• If you have any concerns, ask your specialist if it is necessary to participate.

When not to participate in the population screening

If you have any symptoms or changes that may be related to breast cancer, always see your GP. Do not wait for the invitation from the National Programme for Breast Cancer Screening. Do not make an appointment or participate in the population screening. You should immediately make an appointment with your GP. If you have symptoms after taking part in the population screening, you should also go to see your GP.

There may be other reasons not to participate:  

• If you are being treated for your breast(s).

You do not have to participate in the population screening if you have any issues with your breasts and are being treated by a specialist. If you have any concerns, ask your specialist if it is necessary to participate.  

• In case of severe health problems  

If you are very ill and are not going to get better, participating may not be very useful. Another check might be more suitable for you. Talk to your GP or specialist about what would be best for you.

In case of an increased risk of breast cancer due to hereditary predisposition or because breast or ovarian cancer runs in the family

In some families, breast and ovarian cancer is more common than average. This can be due to a genetic fault. People with this kind of faulty gene are more likely to develop certain types of cancer. Such a fault is called a mutation. It can be discovered with DNA testing at the hospital. A BRCA mutation is a mutation that increases the risk of breast, ovarian, prostate and pancreatic cancers.  

In women with a hereditary predisposition, breast cancer occurs in the family at an early age. Family history research can be used to assess the risk of hereditary predisposition. DNA testing can also be done. However, this test does not always provide clarity, as people are currently primarily tested for a mutation on the BRCA1 or BRCA2 gene. On the website Het zit in de familie (in Dutch) you can check your risk of having this mutation.  

There are also other mutations that can lead to a higher risk of cancer. If you want to know more about hereditary breast cancer, visit the website Hereditary breast cancer - Stichting Erfelijke Kanker Nederland (in Dutch).  

If you have a higher risk of hereditary breast cancer, you will probably have been examined from an early age. The population screening does not have any information about these examinations. That is why you will automatically receive an invitation from the age of 50. We advise you to consult with your GP or treating physician about participating in the population screening.

I do not want to participate in the population screening

If you have decided not to participate in the National Programme for Breast Cancer Screening, you can cancel at:

• Bevolkingsonderzoek Nederland
• Or Mijn Bevolkingsonderzoek (My population screening)

You can choose whether you want cancel your participation just once, or permanently.  

If you have cancelled and want to participate later, please contact the Centre.

Will you still be between 50 and 75 years old in 2 years? If you have not opted out of the population screening, you will    automatically receive another invitation within 2to3 years.  

I want to participate in the population screening

If you want to participate in the National Programme for Breast Cancer Screening, please make an appointment via:

• Bevolkingsonderzoek Nederland
• Or My population screening