Women at risk for breast cancer "should be screened in their thirties"

According to researchers, nearly 86,000 women in their thirties with a family history of bad cancer should have an annual mammogram.

A new study funded by the charity Breast Cancer Now found that cancers had been detected in younger age groups than those covered by the current NHS screening, which often starts at age 40 for women known to be at risk.

The new study suggests that screening should be extended to women aged 35 to 39 with a family history – at a time when tumors may still be small and cancer has not spread.

Baroness Delyth Morgan, Executive Director of Breast Cancer Now, said: "This could be a breakthrough.

"We believe that these findings could change practices and urge the government to review NHS screening programs in the near future to state what additional evidence is needed to consider screening in women aged 35 to 39 with family risk increased bad cancer. "

Research in 34 UK screening centers found that annual mammograms of women aged 35-39 with moderate or high risk of bad cancer detected tumors when they were significantly smaller than a group of undetected women.

The experts also found that early detection meant that tumors were less likely to spread to the lymph nodes – a sign that cancer was spreading throughout the body.

For the study, experts led by a team from the University of Manchester and writing in Lancet's journal EClinicalMedicine examined data from 2,899 women from 2006 to 2015.

The women were all 35-39 years old and at moderate or high risk for bad cancer because of their family history, such as a mother or sister with the disease at an early age.

A total of 50 bad cancers were detected (in 49 women), 35 of which were invasive tumors.

Of the 35 tumors, 80% (28/35) were detected by screening when the tumor was 2 cm or less in size, and only 20% (7/35) was spread to the lymph nodes.

The trial compared the results to a group of women aged 35 to 39 years old at increased risk but not screened.

In this group, far fewer cancers were detected when they were still small (45%) and many more tumors in women had already spread to the lymph nodes.

The researchers said annual screening between ages 35 and 39 could benefit between 64,000 and 86,000 women in the UK.

The current guidelines of the National Institute of Health and Care Excellence (Nice) recommend annual screening of women aged 40 to 49 years old at moderate or high risk of contracting the disease.

Lead author Gareth Evans of the University of Manchester said the results of the new trial were "very promising".

He added, "Our trial shows that mammography screening is effective at detecting tumors earlier in this younger age group, and lays the foundation for extending this screening to women at moderate or high risk to women aged 35 and over. at 39 40 to 49 years old.

"Overdiagnosis is also much less likely to be a major problem in such a young age group.

"For women with a family history, eliminating a non-invasive tumor as early in life will likely have a preventative effect on cancer."

Breast cancer is the leading cause of death among women under 50 in England and Wales – with more than 920 women dying from the disease in 2017.

Breast cancer is the most common cancer in the UK, all ages. Approximately 55,000 women and 350 men are diagnosed each year in the UK.

Experts estimate that about 5% to 15% of bad cancers are linked to a family history of the disease.

Baroness Morgan said, "Early detection is absolutely essential to prevent women from dying from bad cancer.

"Breast cancer remains the leading cause of death for women under the age of 50, we need to find ways to identify the most at-risk individuals and to offer them earlier interventions.

"We have known for a long time that family history can define a woman's risk and that bad cancer can be more aggressive in younger women.

"So, if we can intervene earlier for people at higher risk through annual screening, we think we may be able to stop the disease by ending so many women's lives in such a heartbreaking way."

Baroness Morgan said more research is now needed, especially on the potential costs of extending testing.

A spokeswoman for the NHS England said that a future review of Professor Mike Richards would consider changing the screening program.

"Breast cancer survival is at its highest level and with improved screening, a key goal of the NHS's long-term plan, even more cancers will be diagnosed sooner," she added.