Annual screening for women with history of breast cancer 'may save lives', study suggests
Annual breast screening of women in their 40s who have a family history of breast cancer could save lives, UK scientists have found.
The NHS Breast Screening Programme offers a mammogram every three years to women between the ages of 50 and 70 years. Although it is not centrally organised by the screening programme, women aged 40-49 who are at higher than average risk of breast cancer should already be offered annual mammograms by their GPs.
But the latest research by scientists at Queen Mary, University of London suggests that women with several relatives with breast cancer, or with relatives who were diagnosed with the disease early in life, may benefit from more frequent mammograms starting at an earlier age.
The research team recruited 6,710 women with an intermediate familial risk from across the UK, all of whom received an annual mammogram for an average of four years.
They wanted to see whether annual mammograms had an effect on the stage at which breast cancers were detected, and on women's risk of dying from the disease within ten years of diagnosis.
Results from this group of women (the FH01 cohort) were compared with two other groups of women who had taken part in the UK Age Trial and a Dutch study, most of whom had not been screened.
The scientists found that tumours found in women who were screened tended to be significantly smaller, less likely to have spread to the lymph nodes, and of a lower grade than those found in women from the UK Age Trial.
They were also much less likely to have spread to the lymph nodes than those found in women from the Dutch study.
The research also suggests that women who were screened were more likely to be alive ten years after being diagnosed with invasive cancer than those who were not screened.
According to the researchers, 10,000 women would need to be screened in this way to prevent two deaths from breast cancer within ten years of diagnosis.
Writing in the Lancet Oncology medical journal, the study authors revealed: "Tumour size, node status and grade are highly predictive of future death from breast cancer, and we showed that these characteristics were significantly more favourable in tumours in the FH01 cohort than were those in the two independent comparison groups.
"Our data suggest that, in women younger than 50 years who are at medium or greater familial risk of breast cancer, mammographic surveillance could increase cancer detection, reduce the risk of advanced stage disease and decrease predicted mortality."
Hazel Nunn, senior health information manager at Cancer Research UK, said: "This new study suggests that annual breast screening for women in their 40s with a family history of breast cancer may save lives. But we still don't yet have the full picture.
"Since it seems 5,000 women would need to be screened to save one life, it will be important to weigh up these benefits carefully against potential risks of routine mammography before deciding whether screening really is the best course of action for this group. We await the results of further research measuring the risks."
- FH01 collaborative teams (2010). Mammographic surveillance in women younger than 50 years who have a family history of breast cancer: tumour characteristics and projected effect on mortality in the prospective, single-arm, FH01 study The Lancet Oncology DOI: 10.1016/S1470-2045(10)70263-1