Women aged over 40 who are at increased risk of breast cancer should get annual mammograms
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Women aged between 40 and 49 years who are at increased risk of developing breast cancer because the disease runs in their family should be offered annual mammography, a new UK guideline says. Those at highest risk of developing breast cancer should also get the chance to have a genetic test for the disease and the option of preventive surgery.
Although experts are not yet certain, research suggests that regular breast screening in this age group will help to pick up breast cancers earlier and reduce deaths from the disease. Increasing the availability of mammography will add to the evidence pool to determine whether screening is worth while for this age group, said Dr Jon Emery, a Cambridge GP and Cancer Research UK clinician scientist at Cambridge University.
The guideline, from the National Institute for Clinical Excellence, divides women into three categories: those whose risk of developing breast cancer is near to that of the general population (10-17%), those who have a moderate risk (17-30%), and those who have a high risk (more than 30%).
GPs can estimate a woman's risk by asking about breast cancer in her family, the age such cancer was diagnosed, and the presence of related cancers, such as ovarian cancer, in family members.
Women in the moderate and high risk groups should be referred to a breast cancer team for counselling about possible screening. Women at high risk of developing breast cancer may also be eligible for genetic counselling and testing and should be given the opportunity to discuss preventive surgery.
According to Dr Penny Hopwood, consultant psychiatrist and psycho-oncologist at the Christie Hospital in Manchester, many women with relatives who have had breast cancer and other related cancers have a poor idea of what their own risk is. The new guideline will serve to alert GPs to ask women who seek a consultation because of a breast symptom or because they are worried about the disease in their family and refer them if necessary, she added.
Mr Mark Sibbering, a consultant breast surgeon at Derby General Hospital, said that it will also help to standardise practice across England and Wales and ensure that women receive the most appropriate care. In the past women have been referred inappropriately for mammography and genetic counselling.
An estimated 100000 women of the 3.3 million in England and Wales aged between 40 and 49 have a significant family history of breast cancer. Three quarters of these are expected to approach their GP about their risk, and 13 000 will be found to be at high risk. Of the women at high risk, about 200 each year choose to have preventive surgery.
The new guideline will double the number of women aged 40-49 using breast screening services, and an extra 21 000 mammograms will be required in England and Wales, said Professor Gareth Evans, chair of the guidelines development group and consultant clinical geneticist at St Mary's Hospital in Manchester.(Zosia Kmietowicz)
Although experts are not yet certain, research suggests that regular breast screening in this age group will help to pick up breast cancers earlier and reduce deaths from the disease. Increasing the availability of mammography will add to the evidence pool to determine whether screening is worth while for this age group, said Dr Jon Emery, a Cambridge GP and Cancer Research UK clinician scientist at Cambridge University.
The guideline, from the National Institute for Clinical Excellence, divides women into three categories: those whose risk of developing breast cancer is near to that of the general population (10-17%), those who have a moderate risk (17-30%), and those who have a high risk (more than 30%).
GPs can estimate a woman's risk by asking about breast cancer in her family, the age such cancer was diagnosed, and the presence of related cancers, such as ovarian cancer, in family members.
Women in the moderate and high risk groups should be referred to a breast cancer team for counselling about possible screening. Women at high risk of developing breast cancer may also be eligible for genetic counselling and testing and should be given the opportunity to discuss preventive surgery.
According to Dr Penny Hopwood, consultant psychiatrist and psycho-oncologist at the Christie Hospital in Manchester, many women with relatives who have had breast cancer and other related cancers have a poor idea of what their own risk is. The new guideline will serve to alert GPs to ask women who seek a consultation because of a breast symptom or because they are worried about the disease in their family and refer them if necessary, she added.
Mr Mark Sibbering, a consultant breast surgeon at Derby General Hospital, said that it will also help to standardise practice across England and Wales and ensure that women receive the most appropriate care. In the past women have been referred inappropriately for mammography and genetic counselling.
An estimated 100000 women of the 3.3 million in England and Wales aged between 40 and 49 have a significant family history of breast cancer. Three quarters of these are expected to approach their GP about their risk, and 13 000 will be found to be at high risk. Of the women at high risk, about 200 each year choose to have preventive surgery.
The new guideline will double the number of women aged 40-49 using breast screening services, and an extra 21 000 mammograms will be required in England and Wales, said Professor Gareth Evans, chair of the guidelines development group and consultant clinical geneticist at St Mary's Hospital in Manchester.(Zosia Kmietowicz)