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Breast cancer screening (mammography)
An X-ray of each breast, read by two radiologists, repeated every two years across a band of ages that starts at 40 in Sweden and 50 almost everywhere else. What it finds, what it misses and what a call-back means.
This page describes screening programmes; it is not a diagnosis, not a personal risk assessment and not a substitute for your own health service. Age bands are set nationally and change — the invitation you receive, and the body named on your country page, outrank anything written here. Screening is for people without symptoms: a new lump, blood you can see, a mole that has changed, unexplained weight loss or a sudden change in vision or hearing needs a clinician now, whatever a recent screening result said.
Where it is organised, and at what age
Every country in this region that runs this as an organised programme, with its own age band. Bands differ because national bodies weigh the same evidence differently, not because one of them has it wrong.
| Country | Who | Age band and interval | Test | How it reaches you |
|---|---|---|---|---|
| Estonia | Women | 50–74, every 2 years | Mammography | Invitation |
| Finland | Women | 50–69, every 2 years | Mammography, every 20–26 months | Invitation |
| Latvia | Women | 50–68, every 2 years | Mammography | Invitation |
| Lithuania | Women | 45–74, every 2 years | Mammography | Ask your family doctor |
| Sweden | Women | 40–74, every 2 years | Mammography, every 18–24 months | Invitation |
| Norway | Women | 50–69, every 2 years | Mammography | Invitation |
| Denmark | Women | 50–69, every 2 years | Mammography | Invitation |
What actually happens
You undress to the waist, and a radiographer positions one breast at a time on a plate while a second plate presses down from above. The compression is the part people dread and the part that makes the image work: it spreads the tissue so overlapping structures do not hide a small tumour, and it lets the machine use a lower dose. Two views are taken of each breast, from above and from an angle. The whole visit is around twenty minutes and the imaging itself takes a couple of minutes. Do not wear deodorant, antiperspirant or body cream, because the metallic particles in them show up as specks that look like calcifications. If you still menstruate, days five to fifteen of the cycle are the least tender.
Why two people read it
In the Nordic and Baltic programmes each set of images is read independently by two radiologists, with a third opinion where they disagree. This is not bureaucracy: double reading finds meaningfully more cancers than single reading and is one reason European programmes call fewer women back than American ones. A call-back means the readers want another look, usually with extra views, ultrasound, or both. Being called back is common and is not a diagnosis. The great majority of women who are called back turn out not to have cancer.
What it finds and what it misses
Screening finds cancers that are too small to feel, including ductal carcinoma in situ — abnormal cells confined to a duct, some of which would go on to become invasive cancer and some of which never would. It misses cancers too, particularly in dense breast tissue, where both tumour and normal tissue appear white. It also misses the ones that appear and grow between two rounds; these interval cancers are counted and published by the programmes. A normal mammogram means no cancer was visible on that day, not that none can appear next year, which is why a new lump still needs to be examined even a month after a clear result.
The honest arithmetic
This is the most argued-over screening programme in medicine, and it is worth reading the numbers rather than the headline. The Cochrane review of the mammography trials, by Gøtzsche and Jørgensen, put it like this: for every 2 000 women invited to screening over ten years, one will avoid dying of breast cancer, about ten healthy women will be diagnosed and treated for a cancer that would never have troubled them, and more than 200 will go through a period of anxiety over a finding that turns out to be nothing. Other analyses of the European programmes estimate a larger mortality benefit and less overdiagnosis. Both sets of authors are looking at the same trials. This is why the age bands differ across the region: Sweden reads the evidence as justifying screening from 40, several neighbours read it as justifying screening from 50.
Sources: Council Recommendation of 9 December 2022 on cancer screening (CELEX 32022H1213(01)) · Cochrane Database of Systematic Reviews — Screening for breast cancer with mammography (Gøtzsche and Jørgensen) · Socialstyrelsen — breast cancer screening recommendation · Sõeluuring.ee — what the mammography appointment involves · checked 2026-09-07
Perguntas frequentes
At what age should mammography start?
It depends where you live, and that is not a mistake. Sweden invites from 40, Lithuania from 45, and Estonia, Finland, Norway, Latvia and Denmark from 50. The European recommendation names 50 to 69 as the core, with 45 to 74 suggested as a wider band. All of these are defensible readings of the same trial evidence.
Does a mammogram hurt?
It is uncomfortable rather than painful for most women, and it lasts seconds per view. Compression is what makes a low-dose image readable. Booking days five to fifteen of the menstrual cycle, when the breast is least tender, makes a real difference.
I was called back after screening — does that mean cancer?
Usually not. A call-back means the readers want additional images or an ultrasound of an area they cannot resolve. Most women called back after a screening mammogram do not have cancer, though the days of waiting are genuinely unpleasant.
Should I still check my breasts if I am screened?
Yes. Screening finds cancers you cannot feel; it does not find the ones that appear between rounds. A new lump, a change in the skin or nipple, or a bloody discharge should be examined whatever your last mammogram said and however recently you had it.
The rest of the surface
Cervical screening (HPV test)
Almost every country in the region has switched from looking for abnormal cells to looking for the virus that causes them. The test is better, so the gap between tests is longer — and in several countries you can now take the sample yourself.
Bowel cancer screening (stool test)
A sample from one bowel movement, taken at home and posted. It is the only screening programme in the region that routinely prevents cancers rather than only finding them early — because the follow-up removes the polyp.
Prostate screening (PSA)
Latvia and Lithuania fund PSA testing for men in their fifties and sixties. Sweden assessed the same evidence and recommends against an organised programme. Here is what the trials actually found.
Lung cancer screening (low-dose CT)
The trials are positive and the European recommendation asks countries to build programmes stepwise. In this region it is still pilots rather than invitations — but the eligibility rule is worth knowing.
Abdominal aortic aneurysm scan
The only non-cancer screening programme in the region. Sweden offers men a single abdominal ultrasound in the year they turn 65, looking for a silent widening of the main artery.
What screening can and cannot do
Overdiagnosis, false positives, interval cases and lead-time bias — the four ideas behind every disagreement between countries.
All 27 screening pagesIf the result is not normal
The record that makes the appointment shorter
TempoLife keeps weight, blood pressure, sleep and symptoms in one place, so the questions you get asked at a screening appointment already have answers.