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, 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 and adjustments to be made if necessary.

It is estimated that the first referrals through BARD will be made in late 2018 / early 2019.

Who is included in BARD?

Women identified by BARD 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.
  • At present BARD only captures women with lymphoma as the primary cancer.

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 X-rays of the breasts. These examinations are carried out by women who specialise in mammography screening.

First of all an explanation of the examination will be given and then your breasts will be placed one at a time onto the mammogram machine. A plastic plate will then be lowered onto it to flatten it. This helps to keep your breast still and get clear X-rays. Two X-rays of each breast are usually done - one from above and one from the side. The woman doing the examination will go behind a screen while the X-rays are taken. You have to keep still for several seconds each time.

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 of 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

  • You should know what is normal for you
  • Know what changes to look for
  • Look at and feel your breasts (in any way that is best for you)
  • Tell your GP about any changes as soon as possible
  • Consider going for breast screening when invited

You can read or download the leaflet

 

Opting out of breast screening from an earlier age

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

  • Regardless of a patient’s involvement in BARD, all women will receive an invitation for routine breast screening between the ages of 50-53.
  • Routine breast screening is offered to women aged between 50 and 70 every three years.

If a patient who has been contacted by BARD decides not to have screening from an earlier age, but later changes their mind, then they can still be screened from that date onwards. Patients would need to contact the BARD team (using the details below) who can add their details to the list and inform the correct local Breast Screening Centre.

Postal address:

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

Email: chn-tr.bard@nhs.net

More information

For more information about BARD, the contact details are as follows:

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

Email: chn-tr.bard@nhs.net