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England runs a named screening programme for women who had radiotherapy to breast tissue when young, with exact ages and tests set out in its own documents. Surveillance begins at 25 or 30 depending on your age when irradiated, or eight years after the radiotherapy, whichever is later, and referral runs through a national dataset.
Who is eligible. The NHS Breast Screening Programme's very high risk pathway includes women who received radiotherapy to breast tissue during treatment for Hodgkin or non-Hodgkin lymphoma between the ages of 10 and under 36, and a smaller number who received radiotherapy to breast tissue for cancers other than lymphoma. The programme states that testing "is not applicable" to females irradiated below the age of 10.
The protocol, exactly as published. For females irradiated between the ages of 10 and under 20: annual magnetic resonance imaging from 25 to under 40, annual MRI plus mammography from 40 to under 51, and annual mammography with or without MRI from 51 to under 71. "Surveillance starts at age 25 or 8 years after first irradiation, whichever is the later." For females irradiated between the ages of 20 and under 36: annual MRI from 30 to under 40, annual MRI plus mammography from 40 to under 51, and annual mammography with or without MRI from 51 to under 71, with surveillance starting "at age 30 or 8 years after first irradiation, whichever is the later". Women over 70 who meet the eligibility criteria may be referred through the standard routes, have an initial MRI plus mammography density review, and thereafter self-refer annually if they wish to continue.
How a woman gets on the list. Referral for this group runs through BARD, the breast screening after radiotherapy dataset. BARD identifies women in England below the age of 36 treated with radiotherapy for lymphoma to sites involving breast tissue by taking cancer registry records and cross-matching them against information held at radiotherapy treatment centres and the national radiotherapy dataset. Where eligibility is confirmed, a referral form goes to the local breast screening service; where the woman is below the age of eligibility, her details are held for invitation at the right age. Oncologists wishing to refer a woman irradiated for a cancer other than lymphoma are directed to complete a BARD non-lymphoma referral form and send it to BARD to confirm eligibility.
Two things the programme says about its own limits. Where a woman meets more than one criterion, for example a BRCA1 variant and radiotherapy to breast tissue at 15, the guidance states that her protocol "should be determined on a case by case basis and reviewed by a consultant radiologist, consultant practitioner or breast clinician" rather than by a rule. And on total body irradiation before a transplant, the guidance records that these women "are at an elevated risk of breast cancer in the years following treatment" and that NHS England "will review the evidence to determine if previous TBI reaches the eligibility threshold for the VHR screening programme". That is a national programme naming a group it does not yet cover, which is more useful than a confident answer would be.
If you think you should be on it and are not. The guidance gives a route: "If a woman had radiotherapy involving breast tissue below the age of 36 years but it is unclear if she is eligible for very high risk screening within the NHS BSP, contact BARD for advice", with a named NHS address on the published page. The corpus record on Hodgkin survivorship screening describes the NHS England recall of women treated before 2003 who should have been referred and may not have been, which is the reason this paragraph exists.
What this covers and what it does not. This is England. The other UK nations run their own programmes with similar but separately published protocols. It covers breast tissue only: a woman irradiated to the chest also has the lung, thyroid and sarcoma risks covered on their own records here, and none of those has a programme attached.
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Shares No randomised trial shows that any survivorship screening programme reduces death, Second cancers after radiotherapy, Second cancers after treatment: what the risk is, and what is done about it, Screening survivors: where the UK, American and European answers differ and the tags rejuvenation, survivorship, second-cancers, screening.
Shares No randomised trial shows that any survivorship screening programme reduces death, Second cancers after radiotherapy, Second cancers after treatment: what the risk is, and what is done about it, Screening survivors: where the UK, American and European answers differ and the tags rejuvenation, survivorship, second-cancers, screening.
Shares Ask whether survivorship screening saves lives, using registry-based randomisation, No randomised trial shows that any survivorship screening programme reduces death, Second cancers after radiotherapy, Second cancers after treatment: what the risk is, and what is done about it and the tags rejuvenation, survivorship, second-cancers.
Shares No randomised trial shows that any survivorship screening programme reduces death, Second cancers after radiotherapy, Second cancers after treatment: what the risk is, and what is done about it, Secondary malignancy (therapy-related cancer) and the tags rejuvenation, survivorship, second-cancers, screening.
Shares Second cancers after radiotherapy, Second cancers after treatment: what the risk is, and what is done about it, Screening survivors: where the UK, American and European answers differ, Secondary malignancy (therapy-related cancer) and the tags rejuvenation, survivorship, second-cancers.
Shares Second cancers after radiotherapy, Second cancers after treatment: what the risk is, and what is done about it, Screening survivors: where the UK, American and European answers differ, Secondary malignancy (therapy-related cancer) and the tags rejuvenation, survivorship, second-cancers.
Shares No randomised trial shows that any survivorship screening programme reduces death, Second cancers after treatment: what the risk is, and what is done about it, Secondary malignancy (therapy-related cancer), Survivorship care and late-effects surveillance and the tags rejuvenation, survivorship, second-cancers.
Shares Second cancers after radiotherapy, Second cancers after treatment: what the risk is, and what is done about it, Screening survivors: where the UK, American and European answers differ, Secondary malignancy (therapy-related cancer) and the tags rejuvenation, survivorship, second-cancers.