Annual breast checks recommended

Screening helps detect tumours early

Many women with a family history of breast cancer could receive annual checks for the disease under new guidance.

At present breast screening is offered to the over-50s every three years.

But the National Institute for Clinical Excellence is recommending annual checks for some women in their forties with a family history of the disease.

Having at least one relative who has had the disease, is known to put women at increased risk themselves.

These guidelines will go a long way to allaying fears Professor Peter Littlejohns

The NICE guidance focuses on the best way to treat women in this category.

It covers topics such as the use of genetic tests, and says precautionary mastectomy to avoid the development of cancer may be appropriate.

It is estimated that the cost of implementing the recommendations would be £4.58m in the first year, and £2.47m annually after that.

Better information

Health campaigners welcomed the new advice, saying it would help give women more information about the level of risk they face and their options.

Dr Michelle Barclay, from Breakthrough Breast Cancer, said: "We are encouraged to see that the guidelines recommend that all women from age 40 and with a significant family history of the disease should now be offered annual breast screening and that the importance of reliable support and information has been highlighted.

"Women concerned about hereditary breast cancer tell us how vital access to clear and accurate information is for both themselves and their families."

The advice stresses the importance of women talking to their GP about their concerns.

It says women in their forties whose family history of breast cancer puts them at a moderate risk - defined as 3% to 8% - should be referred to a specialist breast care team to be offered support and information.

Those with a greater risk of developing the disease should be referred to a specialist genetics service for a more detailed assessment, and possibly a test to look for suspect genes.

NICE is also recommending a much faster turnaround of results. At present, it can take years for the results to come back.

Samia al Qadhi, of the charity Breast Cancer Care said: "For a woman, finding out that you have a family history of breast cancer can be devastating.

"It may involve you needing to make very complex and difficult decisions.

"We are extremely delighted that the guidance recognises the importance of access to psychological care and support for women with a genetic link or a concern about a family history of breast cancer."

Precautionary mastectomy

The guidance says that surgery to remove the breasts to avoid cancer developing should be considered, but only for a very small number of women at high risk.

The decision to press ahead should only be taken after full discussion with a doctor, and other support from health professionals.

Mark Sibbering, a consultant breast surgeon, said: "Making the decision to have a mastectomy when you don't have cancer is extremely difficult and not something that any woman enters into lightly.

"There are circumstances when it is advisable for a women to have seemingly healthy breasts removed, but these are rare."

Professor Peter Littlejohns, clinical director at NICE, said: "The worry caused to women by having a history of breast cancer in their family should not be underestimated.

"These guidelines will go a long way to allaying fears and giving women a realistic idea of the risk they face and evidence-based information about the choices for care that are available to them."

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