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When to start getting mammograms if your family has a history of breast cancer

Posted on 9th August 2022 at 06:06

Does your family have a history of breast cancer? If you have first-degree relatives who have suffered from the disease (a parent, grandparent or sibling), then, unfortunately, you are at a higher risk of contracting breast cancer too. In this article, we’re going to be discussing breast cancer, how it is hereditary and whether you can start to get mammograms early when you have familial breast cancer.

What is breast cancer?

Breast cancer is a disease in which cells in the breast grow abnormally and out of control. There are different kinds of breast cancer and the disease can start in different parts of the breast. Breasts are made up of three main parts: lobules, ducts, and connective tissue. The lobules are the glands that produce milk.

The ducts are the tubes that carry milk to the nipple, and the connective tissue surrounds and holds everything together. Most breast cancers begin in the ducts or lobules. If not caught early, breast cancer can spread through blood and lymph vessels to surrounding areas of the body. This is called metastasis. Unfortunately, the more a cancer has spread, the more likely it will prove to be fatal.

What is a mammogram?

Prevention is better than cure. This includes leading a healthy lifestyle and regularly self-checking your breasts Having a mammogram does not decrease the chance of f contracting breast cancer. However, it may to detect any abnormal changes in your breasts as early as possible.

The NHS Breast Screening Programme requests all women from the age of 50 to 70 years for a mammogram every 3 years. A mammogram is an X-ray picture of the breast. Doctors use a mammogram to look for early signs of breast cancer and regular mammograms can detect breast cancer early, sometimes up to three years before it can be felt as a lump.

If you are younger than 50, your risk of breast cancer is generally ow – unless you have first-degree relatives or other close family members who have had the disease. Mammograms are generally more difficult to read in younger women because their breast tissue is denser but with a family history of breast cancer, some women prefer to start having mammograms earlier than the standard offering.

Familial breast cancer and mammograms

Breast cancer is the most common cancer in women in the UK. Between 100 and 120 women in every 1000 develop breast cancer by the age of 80. Men can also get breast cancer, but this is rare.

Occasionally families have a faulty gene, which may be passed down from parents to their children. A person who inherits a fault in a BRCA1, BRCA2 or TP53 gene is at high risk of developing breast cancer. You may be surprised to know that everyone has the BRCA1 and BRCA2 genes. They actually protect us from breast cancer, but when structural changes to the gene happens or it mutates, this then interferes with the proper function of the BRCA gene and stops them from performing accurately and instead causes them to be a threat.

If your first-degree family has a history of breast cancer and you have inherited faulty genes, you may be offered breast screening at a younger age than usual and more frequently. For example, women over the age of 30 who are high risk may start having yearly mammograms. Using scans for the early detection of breast cancer is called 'surveillance'. These scans could eventually lead to every 3 years once they reach the normal recommended screening age of 50. Other women continue to have more frequent screening and it depends on their level of risk.

Get in touch

The table below is what NICE (National Institute for Health and Care Excellence) recommends the following breast cancer surveillance in the UK.

As you can see, 30 is the recommended age to start having yearly mammograms and/or MRIs if you’ve inherited either a BRCA1, BRCA2 or TP53 gene.

Naren Basu’s Family History Clinic

If you’re not keen to leave it all down to the NHS, you may consider booking private breast cancer surveillance. Here at Naren Basu, we have a Family History Clinic where we offer services including:

amilial breast cancer risk assessment

polygenic risk score

gene testing including BRCA1/2

risk-reducing mastectomies – surgery to remove breasts and the risk of cancer

chemoprevention drugs – for patients at a very high risk of cancer with a positive BRCA mutation

Naren Basu is a renowned Oncoplastic surgeon who was previously the Lead Consultant Oncoplastic Breast Surgeon at the QE Hospital, Good Hope Hospital and Solihull Hospital in Birmingham. He studied and qualified at St Bartholomew’s and the Royal London Hospital. While training he studied for an additional degree – Tumour Biology – at the University College London, for which he was awarded a First. He specialises in breast care, breast cancer surgery, breast cancer genetics and all breast-related problems. He uses his plastic surgery techniques to preserve and enhance aesthetic outcomes while eliminating breast cancer risks and tumours. Naren has also written several book chapters on BRCA1/2 mutations and hereditary breast cancers.

Our risk assessment at Naren Basu’s Family History Clinic uses an accurate three-generation investigation. We take into account the number of family members with associated cancers, the ages those relatives developed relevant cancers (the younger the more significant) and bilateral disease.

We have identified single changes in the DNA (called Single Nucleotide Polymorphisms – SNPs) that can alter the risk of developing breast cancer. Using these, we’ve calculated a Polygenic Risk Score (PRS). Mr Basu’s ongoing research as part of the transformation role of the breast services in Birmingham is to try and embed the calculation of Polygenic Risk Scores into standard breast cancer risk assessments. His goal is to offer risk reduction and prevent a significant number of breast cancer cases in the future.