Breast screening After Radiotherapy Dataset

Overview of BARD

Patients cured of a first cancer are at an increased risk of developing a second primary cancer. This is demonstrated in female survivors of Hodgkin lymphoma who received radiotherapy to the chest under the age of 36 and whose subsequent risk of breast cancer is raised. A national Breast screening After Radiotherapy Dataset (BARD) has been set up in collaboration with Public Health England and is designed to optimise screening.

How does BARD work?

BARD has been set up in collaboration with Public Health England and is designed to optimise screening. BARD is a confidential database of women in England who have received radiotherapy involving breast tissue before the age of 36. It has been set up to make sure all those at risk can be informed of screening options at the right time.

  • Current national guidelines recommend that screening should start 8 years after radiotherapy to breast tissue or at age 25 or 30 (depending on circumstances), whichever occurs later.

In addition to making sure that screening appointments arrive at the right time, BARD will allow monitoring of the effectiveness of screening.

The first referrals through BARD will be made in October 2020.

Who is included in BARD?

Women identified as having had radiotherapy to the chest area involving breast tissue before the age of 36. 

  • Radiotherapy to this area is most commonly given for Hodgkin or non-Hodgkin lymphomas but it can sometimes be used to treat other cancers too.

Oncologists and GPs speak to patients explaining that breast screening is offered at an earlier age to women who have had this type of treatment.

When is breast screening offered to women at increased risk following radiotherapy?

Every woman is at risk of developing breast cancer at some stage in her life. Having radiotherapy involving breast tissue before the age of 36 means there is a higher risk of developing breast cancer later in life.

The increase in risk for women who have had radiotherapy will vary based on a number of factors:

  • The age when radiotherapy received
  • The size (area) of the radiation field
  • The dose of radiation received

The increased risk of breast cancer doesn’t occur straight after the radiotherapy. It takes some years to develop. For women who were treated as young adults, there is thought to be no additional risk until approximately 10 years after treatment.

MRI

MRI stands for magnetic resonance imaging. The MRI scanner is a large tube surrounded by a strong magnetic field, with a platform bed that slides into it.

For breast screening, patients will be asked to lie face down on this bed. MRI involves taking many different images of the breast, which may take a while. The scanner makes a loud tapping nose as it scans the breasts.

MRI for breast screening is only carried out at certain centres, as both the equipment and screening staff are specialised and must meet specific screening standards.

Mammography

Mammograms are carried out by women called mammographers. The mammographer will first explain what will happen. She will then place your breast onto the mammogram machine and lower a plastic plate onto it to flatten it. This helps to keep your breast still and get clear X-rays.

The mammographer will usually take two X-rays of each breast – one from above and one from the side. She will go behind a screen while the X-rays are taken. You will have to keep still for several seconds each time.

The whole appointment takes less than half an hour and the mammogram itself only takes a few minutes.

Frequency of screening

Breast screening will be offered once a year (annual screening) according to national imaging protocols.

Breast screening should not be carried out whilst a women is pregnant or breastfeeding.

No screening method can detect every cancer; and cancer can sometimes develop in between screening appointments. If you notice any unusual changes in your breasts, please speak to your GP as soon as possible. Do not wait for your next screening appointment.

Remember to be Breast Aware 

All women should be breast aware. This means knowing how your breasts normally look and feel, and reporting any unusual changes to your doctor as soon as possible. We advise following the ‘touch look check’ (TLC) 3 simple steps: 

  • TOUCH your breasts. Can you feel anything unusual? 
  • LOOK for changes. Is there any change in shape or texture? 
  • CHECK anything unusual with your doctor. 

(TLC information reproduced by permission of Breast Cancer Now.)

Opting out of breast screening from an earlier age

Having breast screening from an earlier age is entirely your choice. Choosing not to have screening doesn’t affect any other aspect of your healthcare.

If you do not wish your name to be included on BARD please let us know you would like to opt out by sending an email to chn-tr.bard@nhs.net – please include your name and NHS number. This is a secure email account to which personal details can be sent safely. The BARD team will then ensure that your details are removed from the dataset. 

If you have your name removed from BARD, you will still receive an invitation for routine breast screening between the ages of 50 and before your 53rd birthday. Routine breast screening is offered every 3 years to all women aged between 50 and before your 71st birthday. 

If you decide not to have screening from an earlier age now, but later change your mind, then you can still be screened from that date. All you need to do is contact BARD (email address: chn-tr.bard@nhs.net) who will add your name to the list.

More information

You can find out about BARD by reading the BARD patient information leaflet.

For more information about BARD, please contact:

BARD
National Cancer Registration Service
North West Branch
3 Piccadilly Place (2nd Floor)
London Road
Manchester M1 3BN

Email: chn-tr.bard@nhs.net