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Cancer Prevention Research
Cancer Prevention Research
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Research Article

Breast Cancer Risk in Young Women in the National Breast Screening Programme: Implications for Applying NICE Guidelines for Additional Screening and Chemoprevention

D. Gareth Evans, Adam R. Brentnall, Michelle Harvie, Sarah Dawe, Jamie C. Sergeant, Paula Stavrinos, Susan Astley, Mary Wilson, John Ainsworth, Jack Cuzick, Iain Buchan, Louise S. Donnelly and Anthony Howell
D. Gareth Evans
1Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Trust, Wythenshawe, Manchester, United Kingdom.
2Genetic Medicine, Manchester Academic Health Science Centre, Central Manchester Foundation Trust, St. Mary's Hospital, Manchester, United Kingdom.
3Manchester Breast Centre, Manchester Cancer Research Centre, University of Manchester, Christie Hospital, Withington, Manchester, United Kingdom.
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  • For correspondence: gareth.evans@cmft.nhs.uk
Adam R. Brentnall
4Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London.
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Michelle Harvie
1Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Trust, Wythenshawe, Manchester, United Kingdom.
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Sarah Dawe
1Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Trust, Wythenshawe, Manchester, United Kingdom.
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Jamie C. Sergeant
1Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Trust, Wythenshawe, Manchester, United Kingdom.
5Centre for Imaging Sciences, Institute of Population Health, University of Manchester, Manchester, United Kingdom.
6NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.
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Paula Stavrinos
1Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Trust, Wythenshawe, Manchester, United Kingdom.
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Susan Astley
1Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Trust, Wythenshawe, Manchester, United Kingdom.
5Centre for Imaging Sciences, Institute of Population Health, University of Manchester, Manchester, United Kingdom.
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Mary Wilson
1Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Trust, Wythenshawe, Manchester, United Kingdom.
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John Ainsworth
7Institute of Population Health, University of Manchester, Oxford Road, Manchester, United Kingdom.
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Jack Cuzick
4Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London.
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Iain Buchan
7Institute of Population Health, University of Manchester, Oxford Road, Manchester, United Kingdom.
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Louise S. Donnelly
1Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Trust, Wythenshawe, Manchester, United Kingdom.
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Anthony Howell
1Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Trust, Wythenshawe, Manchester, United Kingdom.
3Manchester Breast Centre, Manchester Cancer Research Centre, University of Manchester, Christie Hospital, Withington, Manchester, United Kingdom.
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DOI: 10.1158/1940-6207.CAPR-14-0037 Published October 2014
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Abstract

In the United Kingdom, women at moderate and high risk of breast cancer between the ages of 40 and 49 years are eligible for annual mammographic screening and preventive therapy with tamoxifen. Here, we estimate the numbers of women in a population eligible for this service and the proportion of breast cancers detected in this group compared with the whole population. Women <50 attending for mammographic screening in the National Health Service Breast Screening Programme (NHSBSP) completed a risk questionnaire. The proportion at moderate and high risk according to National Institute of Health Care Excellence (NICE) guidelines was estimated. An estimate was also made using a different model of risk estimation (Tyrer–Cuzick). The numbers of cancers detected in the moderate/high risk groups were compared with numbers detected in the whole population. Completed questionnaires were available for 4,360 women between ages 46 and 49 years. Thirty women [0.7%; 95% confidence interval (CI), 0.5–1.0%] were at high risk and 130 (3.0%, 2.5–3.5%) were at moderate risk according to NICE guidelines. Thirty-seven cancers were detected by mammography in the whole group. Five of these were found in the moderate-/high-risk group giving a 3.2-fold increase in detection compared with the standard risk group. More women were assigned to the moderate- or high-risk group using the Tyrer–Cuzick model (N = 384), but the numbers of cancers in this group were not appreciably increased (N = 8). Systematic assessment of family history in primary care or through population-based screening will identify appreciable numbers of women in their forties, eligible for additional surveillance and chemoprevention Cancer Prev Res; 7(10); 993–1001. ©2014 AACR.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Prevention Research Online (http://cancerprevres.aacrjournals.org/).

  • Received January 29, 2014.
  • Revision received June 2, 2014.
  • Accepted July 10, 2014.
  • ©2014 American Association for Cancer Research.
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Cancer Prevention Research: 7 (10)
October 2014
Volume 7, Issue 10
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Breast Cancer Risk in Young Women in the National Breast Screening Programme: Implications for Applying NICE Guidelines for Additional Screening and Chemoprevention
D. Gareth Evans, Adam R. Brentnall, Michelle Harvie, Sarah Dawe, Jamie C. Sergeant, Paula Stavrinos, Susan Astley, Mary Wilson, John Ainsworth, Jack Cuzick, Iain Buchan, Louise S. Donnelly and Anthony Howell
Cancer Prev Res October 1 2014 (7) (10) 993-1001; DOI: 10.1158/1940-6207.CAPR-14-0037

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Breast Cancer Risk in Young Women in the National Breast Screening Programme: Implications for Applying NICE Guidelines for Additional Screening and Chemoprevention
D. Gareth Evans, Adam R. Brentnall, Michelle Harvie, Sarah Dawe, Jamie C. Sergeant, Paula Stavrinos, Susan Astley, Mary Wilson, John Ainsworth, Jack Cuzick, Iain Buchan, Louise S. Donnelly and Anthony Howell
Cancer Prev Res October 1 2014 (7) (10) 993-1001; DOI: 10.1158/1940-6207.CAPR-14-0037
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