Are women being over examined by an over cautious health nanny state?In an uncertain world, we want to believe in the certainty of medicine: that it is omniscient and operates in absolutes. In reality, this is far from the truth. The world of medicine reflects the world we live in; constantly in flux with multifarious contradictions.

Scientists relish this fact. However, for those on the outside, this can be bewildering. We are told one thing one minute, only for it to be ridiculed the next. With its definitions and protocols, medicine serves to give the illusion of stability when, in truth, doctors are all too often unsure.

The furore around breast screening perfectly illustrates this. It began when the Government’s cancer “tsar”, Prof Sir Mike Richards, announced that he is setting up an independent review of the NHS programme.

He has also ordered that patient leaflets, which explain the screening programme, be rewritten to take into account claims by some experts that the benefits have been exaggerated.

Understandably, this has prompted widespread confusion. The issue of breast cancer is always emotive. When I worked in breast surgery, I saw first hand the horrors of this disease on sufferers and their families, and it is vital that we do everything we can to treat and prevent it. But the debate over screening has been raging for some time within the medical community. I remember attending a lecture on this issue when I was at medical school more than 10 years ago.

The NHS screening programme was introduced by the Thatcher government following the 1987 Forrest Report, which recommended a national screening programme for breast cancer for women aged between 50 and 74. The report was based on the most up-to-date research.

But, since then, by comparing countries that have a screening programme with those that don’t, evidence has emerged suggesting that the steady fall in mortality in Western countries is not due to the screening programme, but to improved treatment and service provision.

If this is shown to be true – and it’s still a big if – then this would mean we are needlessly screening thousands of women. And there is an argument that many of the tumours detected by screening would not actually have developed into a life-threatening cancer.

For every screening test, whatever the disease, there is a margin of error. How good a test is can boil down to two things. The first is sensitivity, which measures how good the test is at giving a positive result in those who have the disease. The second is specificity, which refers to how many of those tested are disease-free and test negative.

Now, if you act on the results every time a test records a positive – in the case of breast cancer by doing invasive surgery or giving radiotherapy or chemotherapy – the sensitivity and specificity has to be very high (as near to 100 per cent as possible) to warrant a national screening programme. If it’s not sensitive enough, you’ll be giving women false reassurance when, in fact, tumours are being missed. Similarly, if it’s not specific enough, you’ll be needlessly treating people, with all the associated risks that treatment brings. It is this that is concerning some experts.

They argue that women are being over-diagnosed and over-treated because screening is not specific enough. It can pick up breast abnormalities that may look worrying when biopsied but are actually harmless. It’s a balancing act between saving lives and not causing harm by needless treatment. While doctors are used to adapting to changes in evidence, this is little consolation to women who worry about the disease.

It is perfectly sensible to have an independent review of the research, but I can’t help but think of the women who have had treatment,or are facing treatment, or those who are deciding if they should go for screening. The fact that the current debate waging in the medical establishment is part of the reflexive process that underpins science is of little comfort to them.

Let’s deal firmly with those who fail in patient care

Health Secretary Andrew Lansley should be congratulated – and it’s not often I say that – for his announcement last week that widespread spot checks on hospitals and care homes will be introduced in a drive to improve standards.

The checks will be undertaken by the Care Quality Commission (CQC). It comes after the Government reviewed the findings of the first wave of unannounced visits to care of the elderly wards in the summer. Over half the hospitals inspected had problems, particularly in relation to issues around patient dignity.

Spot checks are the way to tackle this and weed out bad practice and serious failings. But, they will only have any meaning if the CQC – often felt by those campaigning for improved standards as toothless – act on what they find. We don’t need endless reports and bureaucratic stalling. If it will work, the CQC will have to use its muscle. Those in charge of wards and hospitals found to be failing must be held accountable and dealt with firmly.

From: http://www.telegraph.co.uk/the-ifs-and-buts-of-breast-screening

All patients getting cancer treatment should be told to do two and a half hours of physical exercise every week, says a report by Macmillan Cancer Support.
Being advised to rest and take it easy after treatment is an outdated view the charity says.

Research shows that exercise can reduce the risk of dying from cancer and minimise the side effects of treatment.

The Department of Health says local initiatives can get people moving.

Macmillan’s report, Move More, says that of the two million cancer survivors in the UK, around 1.6 million are not physically active enough.

Adult cancer patients and cancer survivors should undertake 150 minutes of moderate intensity physical activity per week, the reports says, which is what the Department of Health guidelines recommend.

In the report, the American College of Sports Medicine also recommends that exercise is safe during and after most types of cancer treatment and says survivors should avoid inactivity.

Getting active, the report says, can help people overcome the effects of cancer and its treatments, such as fatigue and weight gain.

“The evidence review shows that physical exercise does not increase fatigue during treatment, and can in fact boost energy after treatment. It can also lower their chances of getting heart disease and osteoporosis.”

“Also, doing recommended levels of physical activity may reduce the chance of dying from the disease. It may also help reduce the risk of the cancer coming back.”

Previous research shows that exercising to the recommended levels can reduce the risk of breast cancer recurring by 40%. For prostate cancer the risk of dying from the disease is reduced by up to 30%.

Bowel cancer patients’ risk of dying from the disease can be cut by around 50% by doing around six hours of moderate physical activity a week.

Ciaran Devane, chief executive of Macmillan Cancer Support, said physical activity was very important to the survival and recovery process.
Woman jogging Keeping active after treatment for cancer is now recommended by cancer experts

“Cancer patients would be shocked if they knew just how much of a benefit physical activity could have on their recovery and long term health, in some cases reducing their chances of having to go through the gruelling ordeal of treatment all over again.

“It doesn’t need to be anything too strenuous, doing the gardening, going for a brisk walk or a swim, all count.”

Traditionally cancer patients were told to rest after their cancer treatment, but the report says this approach could put cancer patients at risk.

Jane Maher, chief medical officer of Macmillan Cancer Support and a leading clinical oncologist said: “The advice that I would have previously given to one of my patients would have been to ‘take it easy’.

“This has now changed significantly because of the recognition that if physical exercise were a drug, it would be hitting the headlines.”

Martin Ledwick, head information nurse at Cancer Research UK, was a little more cautious.

“Anything that improves wellbeing and reduces treatment side effects for cancer survivors has to be a good thing.

“But the evidence that exercise has a bearing on survival is not conclusive. It is important to remember that no two cancer patients are the same, so rehabilitation programmes that include physical activity will need to be tailored to the individual.”

From: http://www.bbc.co.uk/news/health-14417084

More British women are developing cancer than the average across Europe a leading charity claims.
Official figures suggest almost a fifth more women in this country develop the disease before the age of 75 compared with those on the continent.

The World Cancer Research Fund, which unearthed the data, fears that the difference could be down to the fact that British women drink and eat too much.

Dr Rachel Thompson, Deputy Head of Science for WCRF, said: “On average, women in the UK are more likely to be overweight and to drink more alcohol than the European average and this is a concern because both these factors increase cancer risk.

“They are not the only reasons for the differing cancer rates, but there is now very strong evidence that women who drink a lot of alcohol are at increased risk of developing the disease and that excess body fat is also an important risk factor.

“This is why one of the big public health challenges we face today is to reduce the amount of alcohol we drink as a nation and to get a grip on the obesity crisis before it spirals out of control.

“Together with other factors such as being physically active and eating a healthy plant-based diet without too much salt or red and processed meat, these changes could make a real difference to the number of women who develop cancer before the age of 75.

“Overall, we estimate about a third of the most common cancers could be prevented by eating healthily, being physically active and maintaining a healthy weight. And for breast cancer, which is the most common type of cancer, about four in 10 cases could be prevented through lifestyle changes.”

Recent estimates suggest that four out of 10 Britons will develop cancer at some point in their lives.

The Office for National Statistics reported last month that 130,043 women were newly diagnosed with the disease in England alone in 2009, a rise of 2.6 per cent on the previous year.

By far the most common type among females is breast cancer, with 40,260 cases in 2009. About a quarter of those who develop such tumours die, despite widespread screening and the development of better drugs in recent decades.

According to World Health Organisation figures, 25 per cent of women across Britain develop cancer by the age of 75.

This is almost 20 per cent more than the average of 21 per cent recorded across Europe.

From: http://www.telegraph.co.uk/Womens-cancer-rates-higher-in-Britain-than-Europe

Silicone breast implants are relatively safe despite frequent complications and a small increased risk of the disease lymphoma, US drug regulators have found.
In a new report, the Food and Drug Administration said the risks were well enough understood that prospective patients could make informed decisions.

But it found as many as one in five breast augmentation patients had the implants removed within 10 years.

The FDA released a 63 page report on the safety of the silicone gel filled implants that compiled studies performed by the two companies approved to manufacture the the products.

Approximately five to 10 million women across the world have breast implants, the FDA said.

In 2006, the FDA approved two brands of silicone gel implants for women over 22, Allergan’s Natrelle implants and MemoryGel implants from manufacturer Johnson and Johnson’s Mentor division.

Silicone implants had been off the market since 1992, when the FDA removed them amid concerns about implant rupture and silicone leakage.

The agency allowed saline filled implants to remain on the market, and allowed limited distribution of silicone implants for mastectomy patients and other cases of medical necessity.

According to the new report, as many as one in five breast augmentation patients and half of breast reconstruction patients had to have the implants removed within 10 years.

Studies found no association between the silicone implants and connective tissue disease, breast cancer, or reproductive problems, the FDA reported.

But they did find a “very small” increased risk of anaplastic large cell lymphoma.

The most frequent complications from the implants included implant rupture, wrinkling, asymmetry, scarring, pain, and infection.

The report found that the risk of those local complications increases with time.

“Breast implants are not lifetime devices,” the FDA cautioned women. “The longer you have your implants, the more likely it will be for you to have them removed.”

But the agency also found that most women who had breast implants “report high levels of satisfaction with their body image and the shape, feel and size of their implants”.

“Despite frequent local complications and adverse outcomes, the benefits and risks of breast implants are sufficiently well understood for women to make informed decisions about their use,” the FDA concluded.

From: http://www.bbc.co.uk/news/world-us-canada-13883267

Girls from poorer backgrounds are more likely to start their periods at a younger age, thereby increasing their risk of breast cancer, a UK study says.
It found girls in lower socio-economic groups with typically poorer diets began at 12.1 years on average compared to 12.5 years for wealthier girls.

Their breast cancer risk was greater as they produced the hormone oestrogen longer, the study of 90,000 women says.

It was published in the journal Paediatric and Perinatal Epidemiology.

The research data being gathered from this group of women over 40 years is also helping to find the causes and risk factors associated with breast cancer.

The study is a partnership between Breakthrough Breast Cancer and the Institute of Cancer Research.

This research found that there was little change in the age of menarche (when a girl’s periods begin) for 40 years until the late 1980s.

Then the age dropped from 12.6 years to about 12.3 years, with the drop steepest in poorer areas.

Study author Danielle Morris, from The Institute of Cancer Research in Surrey, said the results suggested that girls, particularly from poorer backgrounds, are starting their periods younger.

“While we don’t know all the reasons behind this, changes in diet may have played a part.

“This decrease is important because the age at which a girl starts her periods can influence her chances of developing breast cancer later in life.”

Dr Tabitha Randall, consultant paediatrician at Nottingham Children’s Hospital, said this was due to exposure to the hormone oestrogen.

“Girls who start their periods earlier are producing oestrogen for longer periods of time, although those who start their periods early normally finish early, but then they may start taking hormone replacement therapy.”

Previous research has shown that the female hormone oestrogen is linked to the growth of breast tumours.

Levels of oestrogen in the body are also influenced by diet and, therefore, body weight.

“Diet is important because fatty tissue turns male hormones into oestrogen,” said Dr Randall.

Girls of lower socio-economic status are now starting their periods at a younger age (12.1 years) than girls from wealthier backgrounds (12.5 years) because they are the ones who tend to have poorer diets and are more likely to be overweight.

The age at which girls start their periods can be added to the list of risk factors for breast cancers, which are known to be a woman’s age, alcohol intake, weight and use of hormone replacement therapy and the contraceptive pill.

A family history of breast cancer may also increase the risk of developing the disease.

Professor Anthony Swerdlow, co-leader of the Breakthrough Generations Study, says that the incidence of breast cancer has risen progressively over a long time in the UK.

“We think these changes have come about through a combination of factors each of which individually makes a small difference.

“Understanding how these factors influence a woman’s risk of developing breast cancer should allow us to develop strategies for preventing the disease in the future.”

From: http://www.bbc.co.uk/news/health-13566411

One in eight women will develop breast cancer as rates have risen over the past decade, according to new figures.
The number of middle aged women contracting the disease has increased particularly sharply, with lifestyle factors partly to blame.

British women are drinking and eating more than before, and exercising less, as well as having babies later in life which also adds to risk.

However early diagnosis and survival rates are improving, with two-thirds of breast cancer sufferers now surviving 20 years or more.

The new figures were published by Cancer Research UK to coincide with World Cancer Day.

Sara Hiom, the leading charity’s director of health information, said: “Women cannot change their genes but small changes in everyday habits can help to reduce cancer risk.

“Cutting back on alcohol by keeping within government recommended limits of no more than 14 units a week (a small drink a day) helps.

“Taking more exercise and eating a diet high in fibre but low in saturated fat can help maintain a healthy weight – which in turn reduces breast cancer risk.

“Women should also discuss hormone replacement therapy with their doctor as long-term use can raise breast cancer risk.

“Mammograms will pick up breast cancers early on before they can be felt as a lump or spotted through other visible changes and we know that the earlier a cancer is detected the more successful treatment is likely to be so women can benefit by taking up invitations to breast screening.”

The data, obtained from the Office for National Statistics, show that in 1999 there were 42,400 women diagnosed with breast cancer in Britain.

By 2008 that figure had risen by 3.5 per cent to reach 47,700, meaning that the lifetime risk has risen from one in nine women to one in eight.

The biggest rise in cases – more than 6 per cent – was among women aged between 50 and 69, while rates dropped slightly among younger generations.

Almost half of those who develop breast tumours are middle-aged, while a third are pensioners and just one in five aged between 25 and 49.

Cancer Research said there is “good news” on survival thanks to improved technology, with three-quarters of women living for at least 10 years after being diagnosis with breast cancer.

Around 1.5 million women are screened for breast cancer in Britain every year and screening every three years will soon be extended to those aged between 47 and 73.

Dr Rachel Greig, Senior Policy Officer at Breakthrough Breast Cancer, said: “These figures are a wake up call and should not be ignored. More women are developing breast cancer and, although survival is improving thanks to breakthroughs in breast awareness, screening and treatment, we clearly have much further to go.

“Some risk factors, such as getting older, cannot be changed but the good news is that others can. By drinking less, maintaining a healthy weight and getting physically active, women can reduce their risk of developing breast cancer.”

Jane Maher, chief medical officer at Macmillan Cancer Support, said: “These figures confirm what Macmillan professionals are seeing on the ground, that breast cancer is continuing to increase.

“There is some good news in that earlier diagnosis and better treatments mean that more women are surviving their cancer. In fact, there are now almost 550,000 women living with a breast cancer diagnosis in the UK.

“Therefore it is vitally important that resources are better used to ensure women get the care and support they need to have a good quality of life after treatment.”

From: http://www.telegraph.co.uk/Breast-cancer-will-hit-one-in-eight-women-study-indicates

Here is a cancer rates league table of the countries with the highest overall rates of cancer, for men, for women and for breast cancer in women, according to the World Cancer Research Fund.

In total there were 12.7 million new cases of cancer worldwide in 2008The latest global figures show that in 2008, there were 12.7 million cases of cancer diagnosed worldwide.

The highest rates of cancer were found in Australia/New Zealand and North America, and the lowest rate was in Africa.

The cancer rate in Australia and New Zealand was nearly three times that in Africa.

Of the total number of cases 48% are in Asia and 25% in Europe. Only 14% of cancers diagnosed worldwide are from regions with the highest rates i.e. Australia, New Zealand and North America. This apparent disparity is likely due to the large population size in Asia.

The most common cancer in men is prostate cancer except for Asia where it is lung cancer. In all regions the most common cancer in women is breast cancer.

Age standardised incidence rates for cancer (excluding non-melanoma skin cancer) in 2008

The tables show the countries with the top ten cancer rates – how many people in every 100,000 develop cancer every year – in four different categories.

Overall cancer rates
1. Denmark (rate: 326.1)
2. Ireland (317)
3. Australia (314.1)
4. New Zealand (309.2)
5. Belgium (306.8)
6. France (Metropolitan) (300.4)
7. USA (300.2)
8. Norway (299.1)
9. Canada (296.6)
10. Czech Republic (295)
[22. United Kingdom (266.9)]

Cancer in men
1. France (Metropolitan) (360.6)
2. Australia (360.5)
3. Ireland (355.9)
4. Uruguay (354.4)
5. Hungary (352.3)
6. Belgium (351.3)
7. Czech Republic (348.8)
8. Norway (338.4)
9. New Zealand (337.6)
10. USA (335)
[33. United Kingdom (280)]

Cancer in women
1. Denmark (325.3)
2. New Zealand (287.1)
3. Ireland (285.1)
4. Israel (280.4)
5. The Netherlands (276.5)
6. Belgium (275.7)
7. Canada (275)
8. Australia (274.4)
9. USA (274.4)
10. Norway (270.3)
[12. United Kingdom (260.5)]

Breast cancer (women)
1. Belgium (109.2)
2. Denmark (101.1)
3. France (Metropolitan) (99.7)
4. The Netherlands (98.5)
5. Israel (96.8)
6. Iceland (95.5)
7. Ireland (93.9)
8. Uruguay (90.7)
9. Switzerland (89.4)
10. New Zealand (89.4)
[11. United Kingdom (89.1)]

From: http://www.wcrf.org/cancer_facts/millions_new_cancer_worldwide.php and GLOBOCAN 2008 http://globocan.iarc.fr

Women in Britain are more likely to be be diagnosed with breast cancer than those in most other developed countries because of their unhealthy lifestyles, according to a new study.
Analysis of data collected by the respected World Health Organisation shows Britain has higher rates of the potentially fatal disease than the USA, Australia, Germany and Spain.

In only 10 of the 50 countries assessed by the researchers do women have a higher chance of being diagnosed with breast cancer than those in the UK.

The experts said that many of the 46,000 breast cancer cases in the UK each year could be avoided if British women drank less, ate more healthily or took more exercise.

More than a quarter of women who develop the disease in Britain die from it, as survival rates have remained low despite record investment in the NHS under Labour.

Professor Martin Wiseman, medical and scientific adviser for the World Cancer Research Fund, which compiled the new study, said: “We know that people in high-income countries are more likely to be overweight, to drink a lot of alcohol and to be inactive.

“When you look at the list, it is clear that the countries that do worse for these factors tend to be nearer the top.

“The high incidence rates in the UK, Denmark and other high-income countries are not inevitable and lifestyle changes can make a real difference to people’s risk.”

Sarah Woolnough, Cancer Research UK’s director of policy, said: “We do know that up to half of all cancers could be prevented by changes to lifestyle such as giving up smoking, keeping a healthy weight and cutting down on alcohol. People can also reduce their risk by eating a healthy balanced diet that is high in fibre, fruit and vegetables and low in red and processed meat.

“All these things, along with taking regular exercise and avoiding sunburn, can reduce the risk of developing cancer.”

More and more British women have been developing breast cancer in recent decades as diets have worsened, excessive drinking has become more common and exercise rates fallen.

Detection rates have improved thanks to the development of advanced screening techniques and increased awareness, but 12,000 women still die from the disease each year as Britain spends less on treatment drugs than other European nations.

Earlier this month the Department of Health announced a new £750 million cancer strategy aimed at saving the lives of 5,000 people a year in England, by giving GPs greater access to advanced diagnosis and improving investment in radiotherapy.

The WHO, through a project called GLOBOCAN, collects figures on the incidence of and deaths from the most common types of cancer for countries across the world, standardised for age in order to aid comparisons.

Its most recent data, analysed by the WCRF for today’s report, show that Belgium had the highest rates of breast cancer in 2008, with 109.2 cases per 100,000 women.

Britain is 11th, with 89.1 cases per 100,000, not as bad as Denmark, the Netherlands, Israel, Ireland or New Zealand but worse than many other leading nations as well as less developed countries where lifestyles are less sedentary. Just 50 in every 100,000 women develop breast cancer in Estonia and Montenegro, for instance.

Britain is the 12th worst of the 50 countries in terms of rates of all cancers among women.

The picture is slightly better for men, where the UK ranks as the 33rd worst. Overall, across both sexes, Britain is ranked 22nd worst out of 50 countries with 267 out of every 100,000 people developing tumours.

International studies have shown that Britons now eat and drink more than their counterparts in many other countries.

Recent figures from the Office for National Statistics show that one in seven women over the age of 16 drinks more than double the recommended daily allowance of alcohol every week, while 24 per cent of women in England are classified obese.

Denmark was given the overall title of “cancer capital of the world”, and although it has a good record of diagnosing the disease, the WCRF said the country’s residents drank a lot and Danish women were heavy smokers.

Meg McArthur, Senior Policy and Information Officer, Breakthrough Breast Cancer, said: “Although these statistics show that we have further to go before we have a future free from the fear of breast cancer in the UK, it is important to remember that more women than ever are surviving due to better screening, improved treatment and greater awareness.

“Breast cancer is thought to be due to a combination of lifestyle, genetic and environmental factors and although some risk factors cannot be changed, women can reduce their risk by drinking less, maintaining a healthy weight and exercising regularly.”

The Government and leading cancer charities insist that Britain’s position near the top of the cancer incidence tables shows that the disease is being picked up by doctors, which aids early treatment, and point out that other countries may not record data so accurately.

Sarah Woolnough, from Cancer Research UK, added: “Comparing cancer incidence rates between different countries can be misleading due to differences in how the data is collected. In some countries, such as the UK, the whole population is accounted for in the data. But in others, coverage is much smaller, so the overall figures might not actually be representative of the whole country.

“Age is the biggest risk factor for cancer, so high-income countries where people live for longer will tend to have higher incidence rates.”

The National Cancer Director, Professor Sir Mike Richards, said: “There are many important factor to consider when looking at cancer incidence figures – for example smoking, alcohol, obesity, and other lifestyle choices.

“We want to vastly improve cancer outcomes – that’s why we will shortly be launching the first ever Government awareness campaign for cancer, to promote earlier diagnosis and to save more lives.”

From: http://www.telegraph.co.uk/Alcohol-and-poor-diet-linked-to-UK-breast-cancer-rates

Dieting for two days every week could reduce women’s chances of developing breast cancer by almost half, scientists have found.
A study found that when overweight women were put on a restrictive diet there was a reduction of up to 40 per cent in cancer-causing hormones following an average drop in weight of 13lb.

The Wythenshawe Hospital study was led by Dr Michelle Harvie and examined 100 overweight women from Greater Manchester, with half following a 650-calorie-a-day diet for two days a week, and the rest following a 1,500-calorie-a-day diet for the entire week.

After six months on the diets, the women’s levels of the hormone leptin was down 40 per cent, their insulin levels down 25 per cent and their levels of inflammatory protein down 15 per cent. All three have been linked to breast cancer.

The other women followed a 1,500-calorie-a day Mediterranean diet. They showed similar weight loss and hormone reductions.

Dr Harvie said the new diet could be a life-saver for women who found it difficult to stay on a diet for a week.

Among the women who took part in the trial was research professor Gillian Haddock, who had been in a high-risk group for the disease. She lost a stone in six months on the diet and is now recommending it to her friends.

Pamela Goldberg, chief executive of the Breast Cancer Campaign, said: “There are many breast cancer risk factors that can’t be controlled, such as age, gender and family history – but staying at a healthy weight is one positive step that can be taken.

“This intermittent dieting approach provides an alternative to conventional dieting which could help with weight loss, but also potentially reduce the risk of developing breast cancer.”

Prof Haddock said: “I felt it was a really good study to be part of, and could provide women with some new options to improve their health.

“I had a family history of breast cancer, so I was relatively high risk. I found traditional diets, with calorie counting and preparations difficult to stick to.

“I used to follow the 650-calorie diet on a Monday and Tuesday and it was great because I knew that by Wednesday I would be eating normally.

“It really suited me, I did it on my busiest work days and I would mainly have the milky drinks while I was at work so I didn’t have to worry about shopping or taking in a specially prepared packed lunch.”

Example of 650 calorie day

Breakfast:
Fruit tea and a banana, or mug of milky coffee

Mid-morning:
Can of diet cola, or cup of tea and plum

Lunch:
Carrot and coriander soup and half-pint of milk, or salad, glass of squash and half-pint of milk

Mid-afternoon:
Glass of squash, or glass of sparkling water and satsuma

Dinner:
Soy sauce and ginger stir-fry with two vegetables and glass of water, or vegetable curry with two veg, half-pint of milk and cup of tea

Supper:
Pint of milk, or hot milk with cinnamon and sweeteners.

From: http://www.telegraph.co.uk/Dieting-for-two-days-a-week-can-almost-half-the-risk-of-breast-cancer

Annual breat screening for women in their 40s with a family history of breast cancer may save lives, research suggests.
The NHS breast screening programme currently offers mammograms to women aged between 50 and 70.

But UK researchers say a pilot study suggests regular mammograms should be given to younger women who have relatives with breast cancer.

A cancer charity said more data was needed to weigh up risks and benefits.

The study, published in the journal Lancet Oncology, looked at women deemed at moderate risk of breast cancer because they have relatives with the disease.

Screening is considered unjustified in women with no family history of breast cancer because of the risk of a false-alarm.

Women at high-risk – because they are thought to have a gene mutation associated with the disease – are already closely assessed, with many given MRI scans or offered early surgery.

The study recruited 6,710 moderate risk women across the UK who were given mammograms to check for signs of breast cancer every year for four years.

These women are not currently included in the main NHS breast screening programme, which offers mammograms to women aged 50-70 every three years.

The researchers, led by Professor Stephen Duffy of Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, compared cancer rates and deaths in this group with women from other trials who were not given annual screening.

They say the women given screening were significantly more likely to be alive 10 years after a diagnosis of cancer than women in the two control groups.

Professor Duffy told the BBC: “It means that annual mammography does reduce the risk of dying of breast cancer in this group of moderate risk women.

“It means they can go and seek medical help knowing that there is something that can be done.”

Rough figures suggest that it would probably save an extra 50 lives a year, he added.

“It doesn’t sound like much but it means alot to the people who are in that group because they have relatives who have had breast cancer,” he explained. “It’s not a huge expense to the NHS.”

But Hazel Nunn, senior health information manager at Cancer Research UK, said the full picture was not yet clear.

“Since it seems 5,000 women would need to be screened to save one life, it will be important to weigh up these benefits carefully against potential risks of routine mammography before deciding whether screening really is the best course of action for this group,” she said.

“We await the results of further research measuring the risks.”

The NHS Breast Screening Programme said plans were in place to extend screening to women with a family history of breast cancer in the future.

Assistant Director, Sarah Sellars, said current guidelines for women at risk of breast cancer because of their family history recommend that certain women should be offered surveillance.

She said these services were currently commissioned locally but in the future would be run by them.

“In the future, the NHS Breast Screening Programmes will be taking on responsibility for routinely screening higher risk women under 50,” she said.

“Several breast screening sites are currently testing the software to be able to manage these women effectively. This service will sit alongside our current breast screening programme for women aged 50 years old and over.”

From: http://www.bbc.co.uk/breast-examinations-should-be-extended