THOUSANDS of lives could be saved if women were screened for breast cancer from the age of 40, says the surgeon who treated Sarah, the Duchess of York.
At present, women are invited for screening at 50. But Dr Christina Choy, one of the surgeons which operated on the Duchess in summer last year, believes a wider screening programme is needed to tackle the fourth most common cause of cancer deaths.
The Duchess of York Sarah Ferguson, 65, only discovered she had breast cancer after a routine mammogram. She was treated by a team at the King Edward VII’s Hospital, a clinic favoured by the Royals.
The Duchess, who became a patron of Prevent Breast Cancer, said that it was “thanks to my mammogram that I’m here today”.
Now Dr Choy has called to make screening more widespread. Dr Choy, who has treated patients as young as 23, believes the current screening system is missing cancer cases because women are not called for mammograms early enough.
Currently, women are only eligible for breast screening from the age of 50. But about 10,000 women under 50 are diagnosed with breast cancer in the UK each year, including 2,400 in their thirties. Breast cancer is the leading cause of death in women aged 35 to 50.
Dr Choy believes women should be screened between the age of 40 and 45.
She also says routine screening should continue until 75 to ensure more cases are picked up – a move that would bring the UK in line with other European nations as well as America and Australia.
She said: “One in seven women now has a lifetime risk of developing breast cancer and while survival has improved compared to twenty years ago, we are currently missing cases because we are not screening women under 50.
“In some countries screening is recommended every year from 40 years old onwards and we all know cancers can develop before the age of 50.
“I have seen patients as young as 23. Dropping the age for screening to start to 40 or 45 would be ideal, but we need the resources to do it.
“Women should be offered earlier screening and it should not stop at 70 if patients want it. This could save hundreds and potentially even thousands of lives.”
She said even women who should be called aged 50 and over were not being contacted for mammograms. Several of her eligible patients have told her they were never even offered the service.
She said: “It is very difficult sometimes – women come and see me with symptoms and I ask if they have been invited for screening and they say they have never been invited even though they should have been. What can they do? Jump up and down in the GP surgery?”
Dr Anmol Malhotra who was part of the team that looked after the Duchess of York said: “There would be benefits from extending the age of screening to women from the age of 40 – up to 14% of all Breast Cancer cases occur in the decade between 40 and 50.
We also know the incidence of adult cancers have increased in the younger population and we are seeing more young people with breast cancer.”
However, Dr Malhotra, a radiologist at King Edward VII’s Hospital added: “We currently do not have the manpower or resources to deliver Breast Cancer screening to younger groups in the UK. We need to be honest with the public about this.”
A further problem is women who do not take up the offer of a mammogram. NHS figures show more than a third of women deemed eligible did not turn up for appointments.
Last year, NHS breast screening services detected cancers in 18,942 women across England, which otherwise may not have been diagnosed and treated until a later stage.
However the latest annual (2022/23) data shows more than a third of women (35.4 percent) did not take up the offer of screening following an invitation, with 2.18 million eligible women not having had a breast screen in the last three years.
Around four in every 100 women screened are asked to come back for more tests after screening and offered care and treatment as required. Of these four women, one will be found to have cancer, with screening preventing an estimated 1,300 deaths from breast cancer each year in the UK.
Dr Choy said: “We have many problems with the current system and backlogs increased as a result of the Covid suppression measures. We need to improve access, and I would like to see screening services outside the 9-5 office hours to increase uptake in women who are too busy to make daytime appointments.”
Around 55,000 women and 400 men are diagnosed with breast cancer every year in the UK. Dr Louise Wilkinson, NHS National Speciality Adviser for Breast Screening and Consultant Radiologist, said: “Breast screening saves lives by allowing cancers to be identified and treated earlier – in fact, discovering breast cancer at the earliest stage may give you a 98 percent chance of surviving for five years or more.”
The Duchess of York underwent an intricate eight-hour operation under the hands of Dr Choy to remove her breast cancer in summer 2023.
After her operation the Duchess publicly thanked Dr Choy along with the King Edward VII’s Hospital medical team.
A Department of Health and Social Care spokesperson said:
“The current age thresholds for screening are decided based on the best available evidence. The UK National Screening Committee keeps all screening programmes under review.
“We are taking decisive action to tackle breast cancer head-on — from launching world-leading AI trials to catch it earlier, to driving forward vital research that improves care and saves lives.
“Our reforms to cancer care will see more than 100,000 people getting diagnosed faster – and thousands more starting treatment within two months.”
