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Final results of the Prospective FH02 Mammographic Surveillance Study of women aged 35–39 at increased familial risk of breast cancer

Final results of the Prospective FH02 Mammographic Surveillance Study of women aged 35–39 at increased familial risk of breast cancer
Final results of the Prospective FH02 Mammographic Surveillance Study of women aged 35–39 at increased familial risk of breast cancer

Background: Many women who are at increased risk of breast cancer due to a mother or sister diagnosed with breast cancer aged under 40 do not currently qualify for surveillance before 40 years of age. There are almost no available data to assess whether mammography screening aged 35–39 years would be effective in this group, in terms of detection of breast cancer at an early stage or cost effective. Methods: A cohort screening study (FH02) with annual mammography was devised for women aged 35–39 to assess the sensitivity and screening performance and potential survival of women with identified tumours. Findings: 2899 women were recruited from 12/2006–12/2015. These women underwent 12,086 annual screening mammograms and were followed for 13,365.8 years. A total of 55 breast cancers in 54 women occurred during the study period (one bilateral) with 50 cancers (49 women) (15 CIS) adherent to the screening. Eighty percent (28/35) of invasive cancers were ≤ 2 cm and 80% also lymph node negative. Invasive cancers diagnosed in FH02 were significantly smaller than the comparable (POSH-unscreened prospective) study group (45% (131/293) ≤ 2 cm in POSH vs 80% (28/35) in FH02 p < 0.0001), and were less likely to be lymph-node positive (54% (158/290, 3 unknown) in POSH vs 20% (7/35) in FH02: p = 0.0002. Projected and actual survival were also better than POSH. Overall radiation dose was not higher than in an older screened population at mean dose on study per standard sized breast of 1.5 mGy. Interpretation: Mammography screening aged 35–39 years detects breast cancer at an early stage and is likely to be as effective in reducing mortality as in women at increased breast cancer risk aged 40–49 years.

BRCA1, BRCA2, Breast cancer, Familial, Mammography, Young
39-46
Evans, D. G.
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Thomas, S.
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Caunt, J.
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Burch, A.
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Brentnall, A. R.
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Roberts, L.
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Howell, A.
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Wilson, M.
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Fox, R.
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Hillier, S.
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Sibbering, D. M.
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Moss, S.
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Wallis, M.G.
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Eccles, D. M.
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Duffy, S.
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FH02 study group
Evans, D. G.
710cd6d0-342a-4244-8d82-f26b8e441ef9
Thomas, S.
351202c8-7737-40c5-8270-281144c3597b
Caunt, J.
e3070329-9b1b-4317-9981-40a738d28cf6
Burch, A.
b5462ab4-d19f-4cb5-8de9-9a380f6ad441
Brentnall, A. R.
c45c5b0c-298d-4ed8-921e-8fe7ece94aaf
Roberts, L.
cd6314eb-ac5b-4609-b4b6-fe31090ccf68
Howell, A.
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Wilson, M.
92a858bd-fcb9-42b9-a22e-ba014da4d549
Fox, R.
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Hillier, S.
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Sibbering, D. M.
b7404da1-4d0c-4a9a-90d1-1fac5dd8b995
Moss, S.
365c4b59-6a83-4c9f-94dd-4152bd1cdf6a
Wallis, M.G.
4db3417d-ce01-4bcb-ace3-e680ab8d0f47
Eccles, D. M.
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Duffy, S.
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Evans, D. G., Thomas, S., Caunt, J., Burch, A., Brentnall, A. R., Roberts, L., Howell, A., Wilson, M., Fox, R., Hillier, S., Sibbering, D. M., Moss, S., Wallis, M.G., Eccles, D. M. and Duffy, S. , FH02 study group (2019) Final results of the Prospective FH02 Mammographic Surveillance Study of women aged 35–39 at increased familial risk of breast cancer. EClinicalMedicine, 7, 39-46. (doi:10.1016/j.eclinm.2019.01.005).

Record type: Article

Abstract

Background: Many women who are at increased risk of breast cancer due to a mother or sister diagnosed with breast cancer aged under 40 do not currently qualify for surveillance before 40 years of age. There are almost no available data to assess whether mammography screening aged 35–39 years would be effective in this group, in terms of detection of breast cancer at an early stage or cost effective. Methods: A cohort screening study (FH02) with annual mammography was devised for women aged 35–39 to assess the sensitivity and screening performance and potential survival of women with identified tumours. Findings: 2899 women were recruited from 12/2006–12/2015. These women underwent 12,086 annual screening mammograms and were followed for 13,365.8 years. A total of 55 breast cancers in 54 women occurred during the study period (one bilateral) with 50 cancers (49 women) (15 CIS) adherent to the screening. Eighty percent (28/35) of invasive cancers were ≤ 2 cm and 80% also lymph node negative. Invasive cancers diagnosed in FH02 were significantly smaller than the comparable (POSH-unscreened prospective) study group (45% (131/293) ≤ 2 cm in POSH vs 80% (28/35) in FH02 p < 0.0001), and were less likely to be lymph-node positive (54% (158/290, 3 unknown) in POSH vs 20% (7/35) in FH02: p = 0.0002. Projected and actual survival were also better than POSH. Overall radiation dose was not higher than in an older screened population at mean dose on study per standard sized breast of 1.5 mGy. Interpretation: Mammography screening aged 35–39 years detects breast cancer at an early stage and is likely to be as effective in reducing mortality as in women at increased breast cancer risk aged 40–49 years.

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Accepted/In Press date: 16 January 2019
e-pub ahead of print date: 10 February 2019
Published date: 2019
Keywords: BRCA1, BRCA2, Breast cancer, Familial, Mammography, Young

Identifiers

Local EPrints ID: 430447
URI: http://eprints.soton.ac.uk/id/eprint/430447
PURE UUID: a4ac00bf-c6ec-4e91-a977-ec5ab858f097
ORCID for D. M. Eccles: ORCID iD orcid.org/0000-0002-9935-3169

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Date deposited: 01 May 2019 16:30
Last modified: 26 Nov 2021 02:34

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Contributors

Author: D. G. Evans
Author: S. Thomas
Author: J. Caunt
Author: A. Burch
Author: A. R. Brentnall
Author: L. Roberts
Author: A. Howell
Author: M. Wilson
Author: R. Fox
Author: S. Hillier
Author: D. M. Sibbering
Author: S. Moss
Author: M.G. Wallis
Author: D. M. Eccles ORCID iD
Author: S. Duffy
Corporate Author: FH02 study group

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