Issues around breast screening

This page presents information on various issues around breast screening, including frequency of screening, number of views taken, informed choice and screening women under 50 with a family history of breast cancer.

Future developments in breast cancer screening

 
 

Frequency of screening

A recent randomised controlled trial to evaluate the optimum screening interval compared annual mammography with three-yearly mammography over a period of seven years. Over 76,000 women were involved and the results showed that shortening the screening interval from the current three years did not produce a statistically significant decrease in the predicted mortality from breast cancer. 1 Therefore the screening interval in the Breast Screening Programme will remain at three years.

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Numbers of views taken at incident (repeat) screens

Originally the breast screening programme took one view of each breast at every appointment. Two view mammography was introduced for prevalent (first) screens following a randomised controlled trial that showed a 24% increase in cancer detection rates as a result of two view mammography at the first appointment. 3

Recent epidemiological evidence supports this result and has shown an increase of 45% in detection of small invasive cancers when double view mammography is used at prevalent screens, and a 42% increase at incident (subsequent) screens. 4 The programme has been extended so that two view mammography is now used at every screen.

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Informed choice

As with the Cervical Screening Programme, the Breast Screening Programme has designed a patient information leaflet to facilitate informed choice. The leaflet outlines what breast screening can and cannot achieve, including an explanation about false positive and false negative results. 5

Copies of this leaflet can be obtained from the NHS Responseline on 08701 555 455, or email doh@prolog.uk.com

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Breast screening for women under 50 with a family history of breast cancer

A large study is underway investigating the effectiveness of mammography in women who have a strong family history of breast cancer.

Ten thousand women aged 40-44 with a significant family history are being recruited and offered annual two-view mammography for five years. The incidence by size, node status and histological grade will be compared with a contemporaneous comparison group and a historical comparison group. 6

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Breast screening - statistics

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References for issues around breast screening

  1.  The frequency of breast cancer screening: results from the UKCCCR Randomised Trial. United Kingdom Co-ordinating Committee on Cancer Research. Eur J Cancer, 2002. 38(11): p. 1458-64
  2.  Moss, S., A trial to study the effect on breast cancer mortality of annual mammographic screening in women starting at age 40. Trial Steering Group. J Med Screen, 1999. 6(3): p. 144-8
  3.  Wald, N.J., et al., UKCCCR multicentre randomised controlled trial of one and two view mammography in breast cancer screening. Bmj, 1995. 311(7014): p. 1189-93
  4.  Blanks, R.G., S.M. Moss, and M.G. Wallis, Use of two view mammography compared with one view in the detection of small invasive cancers: further results from the National Health Service breast screening programme. J Med Screen, 1997. 4(2): p. 98-101
  5.  National Screening Programme. Breast screening: the facts.
  6.  Cuckle H, e.a., Protocol for 'Evaluation of mammographic surveillance services in women under 50 with a family history of breast cancer'. 2002
  7.  Moss SM, Cuckle H, Evans A, Johns L, Waller M, Bobrow L. Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years' follow-up: a randomised controlled trial. Lancet 2006;368(9552):2053-60.
  8.  Moss SM, Brown J, Garvican L, et al. Routine breast screening for women aged 65-69: results from evaluation of the demonstration sites. BJC 2001;85(9):1289-94.