Screening women with a family history of breast cancer - results from the British Familial Breast Cancer Group

Aims: To determine the efficacy of screening women under age 50 with a significant family history of breast cancer. Methods: Results from 22 Breast Units in the UK identified as being able to provide data were surveyed and pooled through regional data managers or consultant breast specialists. Results: Data relating to 8783 women screened and 9075 woman years of follow-up was analysed. Cancer incidence was 11.3/1000/year. The rate of cancer detection was 4.78/1000 at prevalent screening and 4.52/1000 at incident screening. Median age at diagnosis was 43 years. Interval cancers presented at a rate of 2.45/1000. Comparison with the National Health Service Breast Screening Programme for women aged 50-64 revealed a similar rate of cancer detection and a similar incidence of ductal carcinoma in situ. The pathological features of screen-detected cancers in this study strongly suggest that prognosis for these women is more favourable than if they had presented symptomatically. Conclusions: This study provides evidence to suggest that screening young women with a significant family history of breast cancer is effective and that a survival benefit can be expected. As a result the British Familial Breast Cancer Group proposes a co-ordinated prospective observational study.