Breast Cancer: Screening

National Health Service breast screening for women at Very High Risk (VHR) starts earlier and is more frequent than those not at VHR. Guidance on eligibility for VHR screening is available at the following link:

https://www.gov.uk/government/publications/breast-screening-higher-risk-women-surveillance-protocols

The screening includes women:

• with specific proven germline variants;

• determined to be at the equivalent risk for an untested familial variant/unidentified genetic cause; and

• who have received radiotherapy to breast tissue during treatment for Hodgkin and non-Hodgkin lymphoma.

Women who may be at higher risk for breast cancer due to other factors are not currently included within the NHS Breast Screening Programme VHR pathway and any surveillance requirements would be managed outside of the programme. Women who reach the criteria for moderate or high-risk screening with surveillance are currently offered this via family history screening provision managed locally with NHS trusts.

The new and world-leading NHS National Inherited Cancer Predisposition Registry (NICPR), part of the National Disease Registration Service, will help the NHS to deliver proactive, targeted prevention, surveillance, and earlier diagnosis for people and their families. Women at VHR of breast cancer are now identified within the NICPR and referred into the NHS Breast Screening Programme, which has enabled reconciliation to ensure that all identified women are safely referred into the programme. This is a step towards a fully electronic referral VHR process into the NHS Breast Screening Programme.