3 days ago
Breast-cancer checks could begin as young as 30 to catch disease early
Women could be offered breast-cancer checks from the age of 30 under a new approach being trialled by the NHS.
Early findings show almost one in five of those in their 30s have significantly increased risks of breast cancer, the most common cause of death in young women.
Every year, more than 10,000 women in the UK who are too young to be offered screening are diagnosed with the disease, with 2,000 deaths among those below the age of 50.
The study is being led by a consultant at the world-renowned Christie hospital in Manchester, which treated Sarah Harding, Girls Aloud singer, who died from breast cancer aged 39.
Dr Sacha Howell, the lead oncologist on the study, said that in future, all women should undergo 'comprehensive risk assessment' from the age of 30.
This would mean DNA tests and health questionnaires as a minimum, with annual mammograms for some and lifestyle advice for all.
Currently, NHS breast-cancer screening normally starts at age 50, but around one in three women do not come forward for checks.
Ms Harding's former bandmates said the findings were 'astounding' and that the singer, who died in 2021, would have been 'thrilled' that her legacy was making such a difference.
The Breast Cancer Risk Assessment in Young Women (Bcan-Ray) study has tested more than 700 women aged 30 to 39 so far, and aims to recruit 1,000 by the end of June.
The research will compare 750 women who have not had breast cancer and have no strong family history of the disease, with 250 women who have already been diagnosed with breast cancer.
The research is being expanded to other hospitals as NHS officials work on a national cancer plan, which will have the aim of speeding up diagnosis and treatment.
Under the new model, every participant receives a low-dose assessment mammogram, completes a detailed questionnaire, and provides a saliva sample for genetic testing.
The team works with scientists from Cambridge University to calculate each woman's personalised breast-cancer risk score.
On Saturday, Dr Howell will chair a panel on prevention, risk reduction and genetics at a cancer conference hosted by the American Society of Clinical Oncology in Chicago.
Speaking ahead of the event, the oncologist said: 'Breast cancer is the most common cause of death in women aged 35 to 50 in this country and about two-thirds of women who develop breast cancer don't have a family history of it.
'What we want to do is to try and identify women at increased risk so that we can start screening early and reduce the chances of these women dying.'
Dr Howell added: 'I would like all women over 30 to have a breast-cancer risk assessment; that doesn't have to be a mammogram, probably the most powerful part of this is the DNA analysis.'
The study is one of the first in the world to identify new ways to predict the risk of younger women getting breast cancer.
So far, of the 548 cases analysed, 104 – or 19 per cent – were identified as higher-than-average risk.
These are now being offered tailored health advice, including how to cut their risk of cancer through diet and exercise, with annual mammograms scheduled once they cross risk thresholds.
The definition of 'higher risk' means a 3 per cent chance of developing breast cancer in the next 10 years. This is the average risk for a woman aged 50 and over, which is why mammograms are offered routinely then.
The study is the first of its kind for young women, helping to identify those more at risk to offer breast surveillance to detect cancers earlier, when treatment is more likely to be successful.
'Wanted to leave a legacy'
The research is being funded by the Christie Charity's Sarah Harding Breast Cancer Appeal, and contributions from her family and former bandmates.
Dr Howell said the singer had spoken to him many times about 'wanting to leave a legacy for future women'.
The appeal was initiated by the Christie Charity in collaboration with the singer's family, friends, and her Girls Aloud bandmates: Cheryl Tweedy, Kimberley Walsh, Nadine Coyle, and Nicola Roberts.
They said: 'We are so pleased about the progress of the Bcan-Ray study and know that Sarah would be thrilled.
'To hear that women who had no idea they could be at risk of breast cancer are being identified and able to take preventative measures is astounding.
'This study in Sarah's name has the potential to be life saving and we are hopeful the results will be rolled out across the UK allowing doctors to predict and prevent breast cancer for many women. Sarah was an amazing woman and we couldn't be more proud of the legacy she has left.'
Together, the appeal, which is also backed by Ms Harding's family and friends, has raised over £1 million for breast-cancer research.
Around 2,300 women aged 39 and under are diagnosed with breast cancer in the UK each year.
The programme began in the Christie hospital but is being expanded to other NHS cancer units across the UK, including units in Lancaster, Wirral, Bolton, Tameside, Leighton, Wigan and Macclesfield.
Results are expected to be published next year, and fed into the UK national screening committee, after which trials may be rolled out more widely.
It will see how far breast density is a risk factor in younger women, who are known to often have more dense breasts, but are rarely screened. Women with dense breasts are four times more likely to develop breast cancer, but tissue can also mask tumours on a mammogram, making disease harder to spot.
Separate research will compare different methods, to see whether mammograms are required to check breast density.
Breast screening is routinely offered to women aged 50 and over, but millions of women miss out on mammograms, with around one third failing to come forward. Programmes saw a significant dip in uptake during the pandemic, with services closed during the first lockdown.
Simon Vincent, director of research, support and influencing at charity Breast Cancer Now, said: 'While breast cancer is less common in younger women, it's a leading cause of death in women aged under 50.
'Around 2,400 women aged 39 or under hear the words 'you have breast cancer' each year in the UK, and this is why ongoing research, like Bcan-Ray, plays a vital role in helping us to further understand breast-cancer risk in younger women and, importantly, whether the introduction of risk-based screening or screening at a younger age could save more lives from the disease.'
He said the upcoming national cancer plan for England 'presents a critical opportunity to focus on improving access to risk-reduction treatment and early diagnosis tools, that can ultimately help reduce deaths from breast cancer'.
Prof Peter Johnson, NHS national clinical director for cancer, said: 'We are working closely with the Government on a national cancer plan to ensure the NHS continues to deliver progress in diagnosing more cancers earlier and saving lives, and this research provides valuable information about the potential for more personalised approaches to screening.
'If women are worried about any symptoms, whatever their age, or if they notice a change in their bodies or something that's unusual for them, then I would encourage them to contact their GP.'
