Despite the bad press that mammograms are getting at the moment, I remain a firm believer in them and plan to continue to have mine regularly. However, I'm concerned that a report published in the Journal of the Royal Society of Medicine will put women off this potentially life-saving test, delaying cancer diagnosis and ultimately survival chances.

I can't blame any woman reading these findings for feeling confused and worried. I agree that it's a woman's right to be fully informed about the possibilities of false positives plus the full pros and cons of the possible treatment options, and it's clear that more must be done to achieve this.

However, I can't agree with reducing screening to those 'at most risk' because we simply don't always know who they are. As a result, some cancer diagnoses would inevitably be delayed, with fatal consequences. Even if these numbers are small, it's too many in my view. Plus catching a cancer early means there's less chance of a breast having to be removed.

It's true that mammograms have their weaknesses. Effectiveness varies from breast to breast - the more fibrous tissue a woman has, the more difficult it is to be certain about the presence of cancer. This inevitably involves healthy women undergoing more procedures such as a biopsy, which involves inserting a needle guided by ultrasound into the suspicious area to remove cells for analysis. However, speaking as a woman rather than a doctor, I'd rather be safe than sorry.

Unnecessary treatment

It's also true that some slow-growing, non-invasive cancers may end up being treated unnecessarily - but the problem is, it's difficult for doctors to be able to tell which ones these are. A DCIS (ductal carcinoma in situ) is a cancerous growth that sits in the cells lining the milk ducts and hasn't spread. It wouldn't normally be detected because it's symptom-free but a mammogram will pick it up.

Half of these DCISs would cause problems if they went untreated. However, it's difficult to know which these are so doctors often err on the side of caution, recommending treatment when in some cases 'watchful waiting', where a tumour is monitored for changes, may be all that's needed.

I'm not convinced of this study's claim that as many as one in three women are overdiagnosed and overtreated - some overdiagnosis is inevitable but previous research puts the figure more at one in 10. And even the study's authors concede that "screening likely reduces breast cancer mortality", though they claim the government has exaggerated by how much.

However, I am keen for women to have better information. So keep that mammogram appointment but here's what you need to know before you go.

Questions to ask

If you're called back for further treatment after a mammogram, here's what you need to ask the doctor.

1) Do you know for sure that this is cancer or do you only suspect it? If not, what else could it be?

2) What tests are you going to do to determine what it is? How long will they take and what will they involve?

3) If this turns out to be non-invasive cancer (DCIS), ask:

If it is invasive cancer:

1) What are my treatment options? More than 80 per cent of cancers caught early can be treated by removing the lump rather than the whole breast. However, treatment depends on several factors, including the extent of the disease and aggressiveness of the tumour.

2) What are the side effects of the different treatments?

3) If I need a mastectomy, could I have a breast reconstruction at the same time?

4) Could I have counselling on the impact of my treatment?

5) What exercises and other things can I do to help speed up recovery?

6) What are the chances of it coming back?

Your bill of rights

You should expect:

• A confirmed diagnosis within a week of a suspect mammogram.
• A firm diagnosis before consenting to any intervention or treatment including surgery.
• Prompt referral after diagnosis to a team of health professionals specialising in breast cancer.
• Treatment tailor-made to your individual needs.
• Access to a specialist breast cancer nurse who's trained to give information and psychological support.
• Full information about types of surgery and other treatment, including radiotherapy, chemotherapy and hormone therapy.
• Clear and detailed explanation of the aims of the proposed treatments, benefits and possible side effects.
• Reasonable time to consider treatment options (you don't need to make an instant decision)
• A discussion about the pros and cons of breast reconstruction if appropriate.
• The opportunity to meet a former breast cancer patient who's been trained to offer support.
• Information on all support services available to breast cancer patients and their families, including counselling, plus info on false breasts and wigs.

Source: Daily Mirror

Pic: Crystal Woroniuk