A Study is being carried out by a team of researchers at the Genesis Breast Cancer Prevention Centre in Manchester, investigating the impact of mammography screening in women aged between 35 and 39 who have a history of breast cancer within their family. Usually this screening would be offered annually from the age of 40 to those women with an increased risk of the disease. So far the work by the researchers has investigated the type of screening offered to these women at 33 centres around the UK and the initial findings have been published in the journal Familial Cancer.
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The centres participating in the study were asked to record how they chose the women they screened under the age of 40, the manner in which this was conducted and the outcome of screening, including the cases of cancer identified. These findings were compared with those from other research looking at women between the ages of 40 and 49 with a family history of breast cancer (in some studies screening had been performed annually), as well as those involving women at high risk of the disease aged 35 to 39 who hadn’t received screening.
In 27 of the centres women with a family history of breast cancer that places them at higher risk of the disease were already screened between the ages of 35 and 39, which was nearly always by film mammography instead of more up-to-date digital mammography. In all but one of these centres yearly mammography screening was offered and at the other this was every two years; 17 also offered MRI screening, which is usually recommended for women who carry a mutation in one of the genes that places them at very high risk of breast cancer. Of the women attending these screenings between 1994 and 2010, of the 47 occurrences of breast cancer, 22 were identified as a result of this screening, and compared to women who hadn’t received screening the cancers were smaller and more contained, with spread to elsewhere less likely.
Limitations and future work
While researchers report these initial findings as promising, they acknowledge some limitations within the work. Not all the necessary information was gathered out at the point of screening in view of the fact that results were collected after this had taken place, which is why prospective studies are now needed. The actual number of cases of cancer was also too small to determine the actual impact this screening had on cancer rates and equally the survival of these women, which a larger study will help to address. Further research is therefore needed on the impact of digital mammography in women with modest and high risk of the disease to inform the cost-effectiveness of offering this screening routinely.