Breast Screening. NHS Breast Screening Programme Introduced in 1988 Invites women from 50-70 age group for screening every 3 yrs. Age extension roll-out

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    23-Dec-2015

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<ul><li> Slide 1 </li> <li> Breast Screening </li> <li> Slide 2 </li> <li> NHS Breast Screening Programme Introduced in 1988 Invites women from 50-70 age group for screening every 3 yrs. Age extension roll-out in progress includes ages 47-73. Due for completion 2016. Women over 70 can request screening every 3 yrs at their local unit. </li> <li> Slide 3 </li> <li> Why every 3 years? Higher number of false positives with annual screening leading to unnecessary investigations. Why the lower age limit? Only 15% breast cancers occur before age 45. Mammography more difficult to interpret in younger age group due to density of breast tissue. Why upper age limit? May pick up latent cancers which would not have presented clinically within the womans lifetime. Leading to unnecessary intervention. </li> <li> Slide 4 </li> <li> Screening does not prevent cancer developing (unlike Ca cervix) But may detect cancers earlier- giving a better prognosis. For more info on statistics and cancer detection rates see: Breast Screening Programme Report 2008-09: link available from NHS Breast Screening website. </li> <li> Slide 5 </li> <li> Breast Cancer Population risk is about 1:12 5% genetic predisposition Genes that predispose can be inherited by both sexes but not expressed to same degree. High penetrance. BRACA1 &amp; BRACA2, TP53 gene mutations. May get clusters of cancers which are not explained by identifiable genetics. </li> <li> Slide 6 </li> <li> How do we assess genetic risk? Family hx is most reliable way of assessing. Important to identify those at risk as may require increased frequency of screening. Prophylactic mastectomy decreases risk of ca breast by up to 90%. </li> <li> Slide 7 </li> <li> What to ask the patient: Who in the family was affected? Need to look over 3 degrees of relatives What type of cancer was it? The more detail the better: breast, ovary, endometrium, prostate At what age? dont forget males in a family who may be carriers but not express the gene- male with a mother and sister affected counts as an affected relative. </li> <li> Slide 8 </li> <li> Genetic Clues in the FH Two or more closely related people (1 st, 2 nd degree) with same type cancer. Unusual combinations of cancers in a family. Or more than one in an individual eg: breast &amp; ovary, colorectal &amp; endometrial Same cancer in successive generations Cancer at unusual young age- breast/colorectal </li></ul>

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