A significant number of women in the 57 to 60 age group are declining the invitation for breast screening from the National Breast Screening Centre for fear of being diagnosed with cancer, a spokesman for the Centre said.

It seems that a considerable percentage choose to stay away, aligning themselves to the mentality that they would rather not know.

This is unfortunate, a spokeswoman for the Breast Care Support Group told this newspaper, as ignoring cancer will not make it go away. This mentality can be harmful, she said, since it is common knowledge that, with breast cancer, it is a case of the sooner the better, and early diagnosis, resulting in treatment at an earlier stage, may save the woman’s life.

Around one person in every 10 of those who chose to be tested have been called back to the Centre for a second appointment, which usually involves another mammogram, an ultrasound and, in some cases, a biopsy, the Centre spokeswoman said.

Of these recalls, at least nine cases have resulted in a positive diagnosis, she said, which means that nine women have been diagnosed at a relatively early stage and were promptly referred to the multi-disciplinary breast cancer team for a holistic approach to optimising their treatment options.

Consequentially, most of these women will require less aggressive treatments than those who present symptoms of breast cancer. The women whose cancer was detected through the screening system had no symptoms, no palpable lumps, pain or visible breast changes.

Had they not been screened, these women would probably have gone to their GP at a much later stage. This is something that women who are afraid of the results must bear in mind, the Centre spokeswoman said; the earlier the treatment, the less invasive the intervention needed and the greater the chances of a complete recovery.

A breast cancer patient tells how her mother had walked around for six months before having checked a lump she had found, for fear of the result. Unfortunately, by the time she did, it was too late and she lost the battle against cancer 14 months later.

When this patient felt something, on the other hand, she said she immediately had it checked out and five years later she has recovered. This is something that women who are afraid to be tested should learn from, she said.

A spokeswoman for the Action against Breast Cancer Foundation points out that Maltese women are lucky enough to have the equipment and staff available, and should avail themselves of the fact. The service is very user-friendly, she said, and easily accessible.

The set up is better than we ever imagined, she said, pointing out that inconclusive results can be sent abroad for a second opinion from international experts.

The problem of uptake on these services has always existed in Malta, said the spokeswoman. Back when the WellWoman clinics, which tested for cervical cancer, existed in Malta, only 19 per cent of women availed themselves of the service. By failing to take up such services, she said, women ran the risk of losing them.

The National Breast Screening Programme was launched in October 2009 and since then, 1,253 women have been screened. The uptake rate has increased from 30 per cent in October 2009 to around 50 per cent this year, which is satisfactory, considering that the programme is still in its early stages, she said.

Overall, the response was a positive one, and women who have chosen to attend have all expressed their satisfaction and appreciation of the quality and efficiency of the service given.

In the case of the women who chose to turn down the invitation, she said, the staff at the Centre made an effort to contact them to find out what it was that made them reluctant. Although this exercise is time-consuming, it provides valuable feedback.

If a woman is afraid to go for her test, a support group spokeswoman said, volunteers of both groups were prepared to accompany her to give support. She also emphasised the importance of families encouraging women to be tested, as it could save their life.

Of those who have been invited for screening to date, she said, four per cent have had a recent mammogram, four per cent were not interested and another six per cent asked for another appointment to replace the allocated date. These are screened at a later date.

The Breast Screening Centre will focus on increasing its capacity this year, the spokeswoman said, not only in terms of equipment but also in terms of human resources and training.

A second mammography machine has been budgeted for later this year, she said, which is essential to cater for the projected throughput. It will also make the service less vulnerable to machine downtime due to calibration, preventive maintenance, quality assurance and testing, thus ensuring continuity of service.

The Centre has already completed and submitted its activity report up to the end of 2009, as it is keen to fulfil its reporting obligations with the EU on a regular basis.

Increasing attendance rates confirm the trust of Maltese women in the service, and its popularity. As figures demonstrate, only a small minority of those attending have regular mammograms, proving that the service has satisfied a demand in the community.

The spokeswoman said that the quiet room has proved of immense value in conveying results to women and their accompanying family in a calm, non-clinical and reassuring atmosphere and, where neessary, preparing them for the next stage in their care pathway.