Although she felt fit and healthy, actress Samantha Womack had a gut feeling that something was wrong with her. So she had a private ultrasound scan of her breasts which found a 4cm cancerous tumour. Three years after the shock discovery, Womack is clear of cancer after having the tumour removed, plus chemotherapy and radiotherapy.
But she’s urging other women to follow their instincts if they’re concerned about their health in any way, and stresses: “If anything feels wrong, you just have to get as much information as you can and get it checked out, because it literally saved my life I wasn’t quite 50, and I didn’t have a lump – I didn’t have any symptoms. I was generally healthy, and for some reason I just had an instinct that maybe something wasn’t right. So in the middle of two shows, I went to get an ultrasound, and saw a black shadow there. Immediately, when I saw it was an irregular shape, I thought ‘I know what that is’.”
Womack, who played Ronnie Mitchell in EastEnders until 2017, was diagnosed with an aggressive grade three invasive ductal carcinoma in her right breast. The cancer had already started to travel to her lymph nodes, and she had five nodes removed. “The journey then became very much about listening to my instincts and responding to what my body needed, and getting as much information as I could about the cancer,” she explains, “because what if I hadn’t listened to my intuition, my other voice? My diagnosis and treatment would have been very different.”
Now Womack, 52, who divides her time between the UK and her home in the mountains near Valencia in Spain, is championing a campaign to get women who are undergoing breast cancer tests to ask whether their breast tissue is dense or not. The Keep Abreast of your Breast Density campaign by private cancer care provider GenesisCare explains that although mammograms are an excellent breast cancer screening tool, it’s harder to spot tumours in mammograms of dense breast tissue, which is a measurement of how much fibroglandular tissue there is in a woman’s breast versus fatty tissue.
GenesisCare says dense breast tissue is found in around half of women aged over 40, and women with extremely dense breasts are six times more likely to get breast cancer than those with fatty breasts. However, women in the UK are not currently informed about their breast density following a mammogram, and no further additional imaging is offered for women with dense breasts.
Womack says she still doesn’t know if she has dense breasts herself, pointing out: “During the whole process, I hadn’t understood about dense breasts – no-one had mentioned the term to me. But then when I understood, I learned that the denser your breasts, an all-clear with a mammogram doesn’t necessarily mean you’re clear. If you’ve got fatty breasts, tumours are easy to see, but as they become more fibrous, it’s more difficult.”
In the UK, women are routinely invited for NHS breast screening, including a mammogram, between the ages of 50 and 70. Womack is urging women to ask doctors whether they have dense breasts or not, and if they have, then decide whether they want any further tests after a mammogram.
“We still have this mentality of doctors know best and you shouldn’t really push the health service because they’re doing all they can,” she says. “A lot of the time that’s right. But if you feel like there’s anything wrong, and you’re not quite 50, or you’re over 50 and you’ve had a mammogram and you’ve been given the all-clear, but something still doesn’t feel right, the information about whether you have dense breasts can massively change your treatment.
“I just realised how ill-informed we are, and how nervous sometimes we are to ask questions. It’s about taking control of your own body. If anything feels wrong, if you’ve got a lump that’s persistent and won’t go away, if you’ve had a mammogram and it doesn’t feel right, or something is telling you that you should go back, you should listen to that.
“And you absolutely should ask what density your breasts are, because it really makes a difference in terms of finding tumours.”
Womack now has check-ups every six months, and says she’s trying to lead a healthier lifestyle, enjoying walking her six rescue dogs in the mountains around Valencia, where she lives part-time with her partner, actor Oliver Farnworth who plays John Sugden in Emmerdale. “I’ve just chosen to be around nature – it’s a calmer lifestyle. It’s quieter,” she says happily.
“That’s not just because of the cancer – I just enjoy it. I walk the dogs every day, and I try to make good choices about my body. I’m just listening to my body a lot more, I think, rather than being panicked about what I eat and how much I sleep. You can be neurotic about those kind of things. I’m sensible.
“But the main thing is if anything’s wrong, I follow my instinct and I get it checked out. And I really encourage all women to do the same and not be afraid to ask questions.”
But what do independent experts have to say about dense breasts and cancer screening? Sally Kum, associate director of nursing and health information at the Breast Cancer Now charity, confirms: “Having dense breasts both increases the risk of breast cancer and makes it harder to identify potential cancers on a routine mammogram.”
She explains that the UK National Screening Committee (UKNSC) previously looked at offering ultrasound imaging for women with dense breasts after a clear mammogram, but concluded there wasn’t enough evidence to show the benefits outweighed the risks, as the lack of accuracy resulted in more false positives and unnecessary biopsies. Research into breast imaging that could improve cancer detection in dense breasts is ongoing, she says, and if the UKNSC finds evidence supports offering alternative imaging for screening women with dense breasts, the charity intends to push for the changes to be rolled out as quickly as possible across the UK.
“For women who present with possible signs of breast cancer, the diagnostic process is not limited to a mammogram if they have dense breasts and therefore need additional scans to diagnose their cancer,” she says.
“Routine breast screening is the most likely route to finding breast cancer early, and while we acknowledge mammography can be less effective in detecting cancers in dense breasts, we still encourage all eligible women to attend mammogram screening when invited.”
Samantha Womack is partnering with private cancer care provider GenesisCare to encourage women to Keep Abreast of Your Breast Density
