Early detection of breast cancer by surveillance

Women without breast cancer but at moderate or high risk

If you have a moderate or high risk of developing breast cancer you may be offered regular scans of your breasts to check for breast cancer. Using scans for the early detection of breast cancer is called 'surveillance'.

Depending on your age, your estimated risk of cancer and whether you have a faulty gene or a high chance of a faulty gene, your breast care team may offer a mammogram or an MRI scan, or both.

Mammograms and MRI scans take images of the insides of the breasts. Mammograms produce images using low-dose X-rays whereas MRI scans use magnetic waves. The breast care team looks at these images to search for signs of cancer. Not all breast changes are due to cancer.

The type of surveillance recommended by NICE for women of different ages and levels of risk is shown in the table below.

Risk group

Age (years)

Moderate

High

High with more than 30% chance of a faulty BRCA gene

High with a faulty BRCA1 or BRCA2 gene

High with more than 30% chance of a faulty TP53 gene

High with a faulty TP53 gene

20–29

None

None

None

None

Yearly MRI

Yearly MRI

30–39

None

You may have a yearly mammogram

Yearly MRI and possibly yearly mammogram

Yearly MRI and possibly yearly mammogram

Yearly MRI

Yearly MRI

40–49

Yearly mammogram

Yearly mammogram

Yearly mammogram and yearly MRI

Yearly mammogram and yearly MRI

Yearly MRI

Yearly MRI

50–59

You may have a yearly mammogram

Yearly mammogram

Yearly mammogram

MRI if mammogram shows dense breasts

Yearly mammogram

MRI if mammogram shows dense breasts

Mammogram as part of the population screening programme[1]

MRI if mammogram shows dense breasts

You may have yearly MRI

60–69

Mammogram as part of the population screening programme[1]

Mammogram as part of the population screening programme[1]

Mammogram as part of the population screening programme[1]

MRI if mammogram shows dense breasts

Yearly mammogram

MRI if mammogram shows dense breasts

Mammogram as part of the population screening programme[1]

MRI if mammogram shows dense breasts

You may have yearly MRI

70+

Mammogram as part of the population screening programme[1]

Mammogram as part of the population screening programme[1]

Mammogram as part of the population screening programme[1]

Mammogram as part of the population screening programme[1]

Mammogram as part of the population screening programme[1]

None

Women aged 50 to 70 are offered mammograms every 3 years as part of the population screening programme[1]. If you have a family history of breast cancer you may have yearly mammograms or MRI scans after you reach 50, as shown in the table.

Other imaging options

Sometimes women may be offered ultrasound scans when:

  • an MRI scan would normally be used but is not suitable (for example, because they have claustrophobia and do not want to go into the MRI machine), or

  • more investigation is needed after a mammogram or MRI scan.

Women who have had breast cancer

If you have breast cancer you should be offered yearly mammograms for 5 years.

If you have a family history and are at high risk of another breast cancer you should also have:

  • yearly MRI scans if you are between 30 and 49

  • yearly mammograms if you are between 50 and 69 and do not have a faulty TP53 gene

  • mammograms as part of the population screening programme[1] if you are 70 or over and do not have a faulty TP53 gene.

If you have had breast cancer and you have a faulty TP53 gene, you may be offered yearly MRI scans between the ages of 20 and 69 years.



[1] For information and advice about population screening programmes see www.cancerscreening.nhs.uk/breastscreen (England), www.breasttestwales.wales.nhs.uk/home (Wales) and www.cancerscreening.hscni.net (Northern Ireland).

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