21 November 2019
New research published in JAMA Oncology demonstrates how it may be possible to use family history of breast cancer to help adapt the starting age for screening based on individual risk.
The study investigated a more appropriate age to screen an individual based on their family history of the disease, but didn’t look at other factors, whether genetic or lifestyle, that might also increase someone’s risk of developing breast cancer.
From 1932 until 31 December 2015 researchers followed 5,099,172 Swedish women who were known to have one first degree relative - a sister or mother. At the point where researchers stopped collecting information on these women, 118,953 women had been diagnosed with breast cancer and 16,202 of these had a family history of the disease.
Researchers then calculated when the 16,202 women with a family history of the disease reached a 2.2% risk of developing breast cancer in the next 10 years. The general female population are considered to have this risk at the age of 50, which, in the UK, is the point that they are invited to their first routine mammogram.
The study suggests that women with the strongest family history of the disease, who had multiple first degree relatives, with the youngest affected relative being diagnosed with breast cancer before the age of 50, reach the 2.2% risk benchmark as young as 27, and may therefore benefit from earlier screening. Women with only one second degree relative diagnosed with breast cancer reached this threshold at 45, and women with one first degree relative diagnosed reached it at 40.
Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, the research and care charity said:
It’s promising that methods like this could help determine the age at which individual women should be invited to breast screening based on their family history. But more research is now needed to understand how approaches like this could be used in practice alongside key genetic and lifestyle information to begin to tailor women’s screening to their personal level of risk, rather than just their age.
The NHS Breast Screening Programme remains critical to early diagnosis in this country, preventing 1,300 deaths from breast cancer each year. With several risk prediction models in development, we are really hopeful that more personalised ‘risk-stratified’ screening will offer another significant step forward in the early detection and prevention of breast cancer. As the evidence emerges, more targeted screening could help ensure that women who are most at risk can be screened more frequently, while those at low risk can avoid unnecessary scans.
In the meantime, we’d encourage any women concerned about their family history of breast cancer to speak to their GP, and to check their breasts regularly. Just get to know what looks and feels normal for you, check regularly, and report any unusual changes to your doctor. Anyone who is concerned about their family history of breast cancer can also call our free Helpline on 0808 800 6000 and speak to one of our nurses.
Notes to Editor
Currently in the UK women aged 50 to their 71st birthday are invited for a mammogram every three years as part of a national breast screening programme. While those over 71 will not be automatically sent an invitation for screening, they can request to continue to have breast screening. Women with a family history of breast cancer will have the option to have a yearly mammogram from 40 years old.