Breast cancer checks missing lots of at risk younger women, says study

Breast cancer checks missing lots of at risk younger women, says study

Breast cancer remains a significant cause of mortality among women under the age of 50 in the UK. Although roughly one in seven women are diagnosed with breast cancer at some point in their lives, only a small fraction—between 5% and 10%—of these cases are attributable to inherited genetic factors. The vast majority of breast cancer cases, approximately 96%, occur in women over 40 years old, with about a quarter of cases found in women older than 75.

Men can also be affected by breast cancer, with around 420 new diagnoses reported annually in the UK. In England, the National Institute for Health and Care Excellence (NICE) recommends that general practitioners inquire about a woman’s family history if she expresses concerns about her breast cancer risk. This assessment is also suggested particularly for women over 35 who are either using oral contraceptive pills or considering hormone replacement therapy (HRT). While hormones are associated with a slightly elevated risk of developing breast cancer, lifestyle factors such as alcohol consumption and obesity pose a greater overall risk.

A recent study conducted by researchers from Cambridge University and the Institute of Cancer Research has focused on improving breast cancer risk prediction specifically for younger women. The team employed a tool known as Boadicea, which calculates an individual’s risk by integrating various components including family history, genetic data, reproductive history, and lifestyle choices. Their modeling suggests that if all women under 50 were screened using this method, about 26.5% would be identified as having an above-average risk and would be recommended for additional evaluation.

This approach stands in contrast to the current NICE guidelines, under which only 1.4% of women under 50 would be referred for further assessment, capturing merely 4.4% of those who eventually develop breast cancer. The researchers attribute this gap largely to the fact that approximately 73% of women under 50 who develop breast cancer within ten years do not have a family history of the disease, which is the primary focus of the existing NICE criteria

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