What are the current guidelines for breast cancer screening in women aged 50-70 in the UK?

The current guidelines for breast cancer screening in women aged 50 to 70 years in the United Kingdom are primarily managed through the NHS Breast Screening Programme ¹. This programme is a rolling scheme that invites women aged 50–70 years, who are registered with a GP in England, Northern Ireland, Scotland, and Wales, for a routine mammogram every three years ¹.

Women receive an invitation for breast screening by post, and the appointment can be rearranged if the time or place is inconvenient ³. The screening process involves mammography, where each breast is gently but firmly compressed to obtain a good-quality image, which some women may find uncomfortable or painful ³. It is advised to avoid using talcum powder or spray-on deodorant on the day of screening as these may affect the mammogram ³. After screening, women will be contacted with their results; approximately 1 in 23 women are recalled for further tests, although most of these women will not have breast cancer ³. Women should be provided with appropriate information on breast screening, including its benefits and harms, to enable an informed decision about participation ³.

For women aged 50 to 70 years with an increased risk of breast cancer due to family history or genetic factors, specific surveillance recommendations apply ²:

• Moderate Risk (lifetime risk 17% to less than 30%):
  • Women aged 50 to 59 years may be considered for annual mammography ².
  • Women aged 60 to 69 years are offered mammography as part of the population screening programme ².
• High Risk (lifetime risk 30% or greater):
  • Aged 50 to 59 years:
    • If there is a 30% or lower probability of being a BRCA or TP53 carrier, annual mammography is offered ².
    • If untested but with a greater than 30% BRCA carrier probability, annual mammography is offered ².
    • If there is a known BRCA1 or BRCA2 mutation, annual mammography is offered ².
    • If untested but with a greater than 30% TP53 carrier probability, mammography is offered as part of the population screening programme ².
  • Aged 60 to 69 years:
    • If there is a 30% or lower probability of being a BRCA or TP53 carrier, mammography is offered as part of the population screening programme ².
    • If untested but with a greater than 30% BRCA carrier probability, mammography is offered as part of the population screening programme ².
    • If there is a known BRCA1 or BRCA2 mutation, annual mammography is offered ².
    • If untested but with a greater than 30% TP53 carrier probability, mammography is offered as part of the population screening programme ².

MRI surveillance is generally not offered to women aged 50 years and over without a TP53 mutation unless mammography has shown a dense breast pattern ². However, for women aged 50 to 69 years with a known TP53 mutation or a greater than 30% probability of being a TP53 carrier, annual MRI surveillance may be considered ².