Breast Cancer Screening in Switzerland

My name is Dr Michelle Wright. Welcome to my Health Matters podcast.

I’m a British-trained doctor and General Practitioner, and I’ve been living and working in Switzerland for over 20 years.

In each episode, I bring you clear, evidence-based health information, relevant to your life here.

October is Breast Cancer Awareness Month, often called Pink October. Alongside the pink ribbons and awareness campaigns, it’s an opportunity to understand what someone can do to support their own personal breast health.

So, today, I’m looking at breast cancer screening in Switzerland. Who is it for? What happens during a mammogram? And what are the benefits and limitations we should understand before deciding whether to take part?

First, an important distinction. Screening is designed for people who haven’t noticed any symptoms. The aim is to find a cancer at an early stage, before it can be felt or causes other changes, and when treatment is often less extensive and the chances of successful treatment are better.

If you’ve already noticed a breast change, don’t wait for a screening invitation. Make an appointment to discuss your concerns with your doctor.

So, how does screening work here in Switzerland?

Well, for women aged 50 and over, mammography is the main method used to screen for breast cancer. It’s a special X-ray examination that can identify very small changes in breast tissue.

The Federal Office of Public Health and the Swiss Cancer League recommends organised mammography screening programmes for women from the age of 50. The upper age limit varies between programmes: some include women up to 69, others up to 74.

If you live in a canton with a programme, you’ll normally receive a written invitation through the post every two years. And, importantly, eligibility doesn’t depend on your nationality.

Not every canton has a programme, so it’s worth checking the Swiss Cancer Screening website for the arrangements where you live. If you’re eligible but haven’t received an invitation, contact your local programme.

And if there isn’t a screening programme in your area, talk to your gynaecologist who’ll be able to discuss mammography with you.

Now, what about the cost?

Within an organised programme, the mammogram is covered by basic health insurance and is exempt from your annual deductible.

You’ll usually pay only the ten per cent contribution, generally around 20 Swiss francs, although the exact amount varies, and some cantons cover this too.

If further investigations are needed, the usual deductible and contribution generally apply. And screening outside an organised programme doesn’t automatically have the same insurance cover, so do check beforehand.

What can you expect at the screening appointment?

Well, you should allow around 20 to 30 minutes, although taking the X-rays themselves only takes a few minutes.

You’ll be asked to undress from the waist up. And a specially trained radiographer positions each breast between two plates, which gently but firmly compress it for a few seconds.

That pressure helps produce a clear image while keeping the radiation dose low. It can feel uncomfortable, and some people find it painful, so tell the radiographer how you’re feeling.

A practical tip: wear a separate top and bottom, and also avoid deodorant, powder or body lotion on your breasts and armpits that day, because these can affect the images.

You should also tell the service beforehand if you have breast implants or need any adjustments to help you attend.

Within an organised programme, the images are assessed independently by two radiologists. You won’t usually receive the result during the appointment. Instead, it’s sent to you afterwards, generally within about eight working days. And your doctor can receive a copy too.

So, what are the benefits of screening?

Well, as I mentioned, the intention of screening is to find a cancer before it causes symptoms, when it’s smaller and less likely to have spread. This can mean less extensive surgery and, for some women, less intensive treatment.

Screening also reduces the risk of dying from breast cancer.

To put that into perspective, the Swiss Cancer League estimates that among 1000 women screened every two years over 20 years, around 16 die from breast cancer, compared with around 20 without screening.

That’s approximately four fewer breast cancer deaths per 1000 women over those 20 years. Of course, these are population estimates, rather than a prediction for any individual person.

But screening does have limitations, and participation is voluntary.

One possibility is a false alarm. A mammogram may show something that needs a closer look, but further tests reveal that it isn’t cancer.

Those tests might include additional mammogram images, an ultrasound, or sometimes a biopsy – taking a small tissue sample.

Most women called for further investigations don’t have breast cancer. But of course, the uncertainty and waiting can be very stressful.

There can also be false-negative results: a cancer may be present but not visible or recognised on the mammogram. And a cancer can develop between screening appointments.

That’s why a normal result should never be a reason to ignore a new breast change.

Another limitation is possible overdiagnosis. This means finding a cancer that would never have caused symptoms or shortened someone’s life.

The difficulty is that doctors can’t reliably tell which cancers would remain harmless throughout a person’s lifetime. And as a result, some people receive treatment they would otherwise never have needed.

Mammograms also involve a small dose of radiation. But for those in the recommended age group, this risk is considered small compared with the potential benefit.

Weighing up these benefits and risks, as I said, the Swiss Cancer League and the Federal Office of Public Health support organised screening programmes, while recognising that each person needs clear information to make their own decision.

And what if you’re younger than 50, or have breast cancer in your family?

If this is the case, my advice is to speak to your doctor about your individual risk. Some people need earlier, or different checks.

And of course, if you’ve previously had breast cancer, your follow-up should also be individually planned.

Finally, whatever your age, get to know how your breasts normally look and feel.

A new lump in the breast or armpit, skin dimpling, a change in breast shape, a newly pulled-in nipple, or unexpected nipple discharge should always be checked.

Most breast changes aren’t cancer, but they do deserve medical attention, even if your last mammogram was normal.

So, this Pink October, take a moment to check what screening is available to you, ask any questions you have, and seek advice about breast changes quickly.

You’ll find further details about cantonal screening programmes at swisscancerscreening.ch. And the Swiss Cancer League, your GP, or your gynaecologist can also help.

That’s it for this episode of Health Matters. If you found it useful, please like, share, and follow on Instagram, Facebook, LinkedIn and Spotify – it helps others find reliable health information in English.