SCREENING WOMEN AGED LESS-THAN 50 YEARS WITH A FAMILY HISTORY OF BREAST-CANCER

Family history is an important breast cancer risk factor and is a comm on reason for referral to specialist breast clinics for consideration of breast screening. The aims of this study were to determine cancer d etection rates and prognostic features of breast cancers identified in women aged less than 50 years at increased risk of breast cancer who attend a Family History Breast Screening Clinic (FHC). Between January 1988 and December 1995, 1371 asymptomatic women aged less than 50 yea rs underwent annual clinical breast examination and biennial mammograp hy due to a family history of breast cancer. A total of 29 cancers (23 invasive and 6 in situ) were detected or presented as interval cancer s during a mean follow-up of 22 months (range 0-96 months). This gave a relative risk for invasive breast cancer in this high-risk group of 5 when compared with an age-matched female population in the U.K. The cancer screening detection rates were similar to those of women aged 5 0 years or over undergoing population screening in the NHS Breast Scre ening Programme (NHSBSP)-FHC prevalent screen 8 per 1000 screening vis its versus NHSBSP 6.5 per 1000, FHC incident screen 3.3 per 1000 scree ning visits versus NHSBSP 3.8 per 1000. A higher proportion of in situ cancers were detected in the FHC screened group compared with cancers identified in symptomatic patients from an age-matched risk group (21 % versus 4%). No differences were demonstrated for invasive tumour siz e, grade or lymph node stage between symptomatic and screened women. T he early results of this study suggest that young women at risk of bre ast cancer due to a family history may benefit from regular breast scr eening due to the early detection of in situ lesions. (C) 1998 Elsevie r Science Ltd. All rights reserved.