/23 June 2013
The first stage of a new research programme on screening younger women (35-39) with a family history of breast cancer has published its findings. The results led the Daily Telegraph to pronounce women with a family history of breast cancer should be screened in their 30s.
The research by the Breast Cancer Prevention Centre at the University Hospital of South Manchester NHS Trust, among others, suggests earlier breast screening of high risk groups, is effective at identifying breast cancer earlier. Earlier detection is important: Early stage breast cancer is less likely to have spread to the lymph nodes, increasing the chance of recovery.
There has been debate about what screening is effective and cost-effective. Current national guidelines say women at greater risk due to family history should have an annual mammogram from age 40 with those at very high risk being given the option of an annual MRI scan from age 30.
The new report, a retrospective study, looked at the type of screening offered to younger women at 33 centres across the UK. Most of these followed the national guidelines. However the 5 centres with the most rigorous follow-up, saw most early stage tumours identified through screening with a third identified between screenings.
The study also found film mammography was still in widespread use, no centre routinely offered ultrasound, and only 17 centres offered MRI. Therefore within the national guidelines there is widespread variation in how screening is conducted.
Comparing these results with those from unscreened women showed the cancers identified were likely to be smaller and less developed and less likely to have spread. Hence the Daily Telegraph’s headline.
However the centres included in the research, do not as a rule, collate information enabling them to determine how effective screening is for women aged 35 to 39. Therefore this research will have a second part, a prospective study, focusing on 2,800 higher-risk women as they have annual screening up to 2016. Contrary to what the Daily Telegraph says, it is this research which will look more closely at the benefits of annual mammograms in younger women and the cost effectiveness of the programs.