New research suggests current UK screening guidelines fail to identify many younger women at risk of developing breast cancer.

A study by researchers from Cambridge University and the Institute of Cancer Research indicates that current National Institute for Health and Care Excellence (Nice) guidelines for breast cancer assessment miss a significant portion of women under 50 who are at risk. The researchers evaluated a risk-prediction tool called Boadicea, which incorporates family history, lifestyle, reproductive history, and genetic data to identify women who may require further assessment.

Limitations of Current Guidelines

Current Nice guidance in England focuses heavily on family history when determining whether a woman should be referred for further breast cancer assessment. However, the study found that 73% of women under 50 who develop breast cancer within a decade have no family history of the disease. Consequently, current criteria result in only 1.4% of women under 50 being referred, capturing just 4.4% of those who eventually develop the condition.

Potential for Improved Risk Prediction

The researchers estimate that using the Boadicea risk calculator for all women under 50 would identify 26.5% as being at above-average risk. This approach would capture 34.8% of women under 50 who develop breast cancer within 10 years. While hormones are linked to a slightly increased risk, the study notes that larger risk factors for breast cancer include obesity and alcohol intake.