Breast cancer screening should begin at 35 for 'at risk' women

Breast cancer screening should begin at 35 for at-risk women as this would pick up thousands of cases earlier and therefore save lives, experts have suggested.

Charity Breast Cancer Now funded a study which found cancers were detected sooner when 35 to 39-year-olds with a family history of the condition had annual mammograms.

Under current NHS guidelines, women are not regularly screened until the age of 40, but bringing testing forward could see an extra 86,000 women undergoing check-ups every year.

The government is due to review current screening guidelines and is being urged by charities to begin mammograms earlier for those who are considered more at risk.

The study, carried out by researchers at the University of Manchester and published in The Lancet’s online journal EClinicalMedicine, offered scans to 2,899 women aged 35 to 39 who were at risk of cancer due to their family history and compared the results to a group who had not undergone screening early.

The screening detected 35 invasive breast cancer tumours, most of which were small and identified before they had reached the lymph nodes, a sign that they had not spread around the body.

In a control group, which did not have the screening, far fewer of the cancers were discovered when they were still small and more had spread to the lymphatic system.

Commenting on the findings lead study author, Professor Gareth Evans, described the results of the research as “very promising”.

“Our trial shows that mammography screening is effective in detecting tumours earlier in this younger age group, and lays the groundwork for extending this screening in women at moderate or high risk down to women aged 35 to 39 from ages 40 to 49,” he said.

“Over-diagnosis is also far less likely to be a major issue in such a young age group.

“For women with a family history, removing a non-invasive tumour so early in their lives is likely to be a cancer preventive.”

But there is a need to balance the advantages of doing more checks against causing any undue worry or over-treatment.

So study authors recommended that further analysis be carried out on the risks, costs and benefits of extending the screening programme.

According to Breast Cancer Now, while more women are now surviving the disease than ever before, breast cancer remains the leading cause of death in women under 50 in England and Wales – with over 920 women under 50 losing their lives to the disease in 2017.

Breast cancer is the UK’s most common cancer, with around 55,000 women and 350 men being diagnosed each year in the UK – and it is estimated that around 5-15% of cases are linked to a family history of the disease.

An NHS England spokeswoman said possible changes to the screening programme will be considered in the review.

She said: “Breast cancer survival is at its highest ever and with improved screening a key focus of the NHS long-term plan, even more cancers will be diagnosed earlier.”

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