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Wednesday, 6 November, 2002, 19:00 GMT
Screening alert for 'at risk' women
One in 200 women have BRCA mutations
Women who are genetically predisposed to breast cancer should avoid having mammograms, a controversial study suggests.

Researchers in Germany believe the low-energy X-rays used in mammograms may increase the risks of these women developing the disease.

But British experts have criticised the study and warned women that mammography plays a key role in spotting breast cancer early.


I don't believe these findings have any implications for breast cancer screening in general

Dr Roger Cox, National Radiological Protection Board
The findings also contradict a US study published earlier this year which suggested medical radiation did not increase the risk of breast cancer in women.

An estimated one in 200 women have mutations in the so-called BRCA1 and BRCA2 genes, which have been linked to breast cancer.

At the moment, doctors encourage these women to have annual mammogram check-ups.

However, Dr Marlis Frankenberg-Schwager and colleagues at the University of Gottingen said their findings raise questions about this policy.

Damaged genes

They found that mammograms are nearly three times more likely to cause genes to mutate compared to conventional X-rays.

Writing in the International Journal of Radiation Biology, the researchers said the low-energy X-rays could damage the genes in 16 out of every 100 million cells.

They said women with healthy BRCA genes were not at risk because there was only a remote chance that both of the breast cancer genes could be damaged by the screening.

But they said the risks were "big" for women who have mutated BRCA genes.

"It's a big risk for these women," Dr Frankenburg-Schwager told New Scientist magazine. "It is worrying."

She added: "Women with an increased breast cancer risk should avoid frequent and early mammography screening."

However, the UK's National Radiological Protection Board rejected the suggestion that women who are predisposed to breast cancer should not have mammograms.

Dr Roger Cox, of the NRPB, said the German research was speculative.

"I don't believe these findings have any implications for breast cancer screening in general.

"With regard to women who are genetically susceptible to breast cancer, they should probably be considered on a case by case basis," he told BBC News Online.


Mammography is still a valuable tool in the detection of early breast cancer

Bernie Gardiner, Breast Cancer Care
Nevertheless, the German researchers suggested that International Commission on Radiological Protection work in this area fail to take their findings into account.

Dieter Frankenburg, one of those involved in the study, suggested the risks were higher than 1%.

Stark choice

A recent study by doctors in Belfast suggested that young women with mutations in the BRCA1 gene may be best advised to have both breasts removed.

Richard Kennedy who carried out the study said the women must also be aware of the risks of regular mammographies.

"These women have a choice between surgery and regular screening and they must be aware of the risks of both," he said.

But Bernie Gardiner, an information nurse at Breast Cancer Care, said further study is needed.

"In the UK, women who are high risk of breast cancer are managed in accordance with the national guidelines and mammography is not recommended in women under 35 years of age.

"Although the findings of this research are interesting and should be followed by further work, mammography is still a valuable tool in the detection of early breast cancer.

"This illustrates the kind of difficult choices that women who have hereditary breast cancer face. This is why it is so important that they access to information and support to make the decisions which are right for them."

See also:

17 Oct 02 | Health
29 Sep 01 | Health
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