Call to extend breast screening

18 November 2010 Last updated at 00:32 ET By Helen Briggs Health reporter, BBC News

Annual screening for women in their 40s with a family history of breast cancer may save lives, research suggests.

The NHS breast screening programme currently offers mammograms to women aged between 50 and 70.

But UK researchers say a pilot study suggests regular mammograms should be given to younger women who have relatives with breast cancer.

A cancer charity said more data was needed to weigh up risks and benefits.

The study, published in the journal Lancet Oncology, looked at women deemed at moderate risk of breast cancer because they have relatives with the disease.

Screening is considered unjustified in women with no family history of breast cancer because of the risk of a false-alarm.

Women at high-risk - because they are thought to have a gene mutation associated with the disease - are already closely assessed, with many given MRI scans or offered early surgery.

False alarms

The study recruited 6,710 moderate risk women across the UK who were given mammograms to check for signs of breast cancer every year for four years.

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"Start Quote

It will be important to weigh up these benefits carefully against potential risks of routine mammography before deciding whether screening really is the best course of action for this group"

End Quote Hazel Nunn Cancer Research UK

These women are not currently included in the main NHS breast screening programme, which offers mammograms to women aged 50-70 every three years.

The researchers, led by Professor Stephen Duffy of Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, compared cancer rates and deaths in this group with women from other trials who were not given annual screening.

They say the women given screening were significantly more likely to be alive 10 years after a diagnosis of cancer than women in the two control groups.

Professor Duffy told the BBC: "It means that annual mammography does reduce the risk of dying of breast cancer in this group of moderate risk women.

"It means they can go and seek medical help knowing that there is something that can be done."

Rough figures suggest that it would probably save an extra 50 lives a year, he added.

"It doesn't sound like much but it means alot to the people who are in that group because they have relatives who have had breast cancer," he explained. "It's not a huge expense to the NHS."

Surveillance

But Hazel Nunn, senior health information manager at Cancer Research UK, said the full picture was not yet clear.

"Since it seems 5,000 women would need to be screened to save one life, it will be important to weigh up these benefits carefully against potential risks of routine mammography before deciding whether screening really is the best course of action for this group," she said.

"We await the results of further research measuring the risks."

The NHS Breast Screening Programme said plans were in place to extend screening to women with a family history of breast cancer in the future.

Assistant Director, Sarah Sellars, said current guidelines for women at risk of breast cancer because of their family history recommend that certain women should be offered surveillance.

She said these services were currently commissioned locally but in the future would be run by them.

"In the future, the NHS Breast Screening Programmes will be taking on responsibility for routinely screening higher risk women under 50," she said.

"Several breast screening sites are currently testing the software to be able to manage these women effectively.

"This service will sit alongside our current breast screening programme for women aged 50 years old and over."

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Kidney zap lowers blood pressure

17 November 2010 Last updated at 09:19 ET By Michelle Roberts Health reporter, BBC News <!-- Embedding the video player --> <!-- This is the embedded player component -->

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Fred Quatromini: Trial treatment "has done something that tablets can't do, to me anyway"

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A short blast of radio waves to the kidneys can help control high blood pressure in patients who do not respond to medication, a study shows.

The pioneering work, described in The Lancet medical journal, selectively severs nerves to the kidney that play a key role in regulating blood pressure.

Although still in the testing phase, experts say the procedure could one day help hundreds of thousands of patients.

Half of patients fail to achieve good blood pressure control with drugs.

This is partly because it can be difficult to remember to take medication every day. But for up to a fifth of patients it is because the drugs simply have no effect.

High blood pressure is an exceedingly common condition, affecting around one in three adults in England.

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This trial opens up a potentially exciting new avenue for the treatment of patients with high blood pressure who do not respond well to current medicines"

End Quote Professor Jeremy Pearson British Heart Foundation

Experts believe the new procedure could help many of these better control their condition, thereby lowering their risk of future strokes and heart attacks.

Promising results

Doctors led by Professor Murray Esler at the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, have been testing the safety and effectiveness of the therapy.

To get to the kidneys, the doctors use a long, thin piece of tubing called a catheter that is threaded into an artery in the groin and guided up to the kidney.

Once in place, the catheter is connected to a machine that generates radio waves, known as radiofrequency energy.

In this way, a short burst from the machine can knock out a number of tiny nerves that run in the lining of the arteries of the kidney.

By stopping these nerves from sending signals the treatment lowers blood pressure.

The Australian team, working with 24 centres across the globe, have tested the treatment in trials involving more than 100 patients.

They found the therapy lowered blood pressure by about 10mmHg or more - which although is not enough to return blood pressure to a 'normal' level is enough to reduce some of the associated health risks of very high blood pressure.

And, importantly, there were few side effects if any.

Six months after the treatment, 41 (84%) of 49 patients who underwent the procedure had a reduction in systolic blood pressure of 10mmHg or more, compared with 18 (35%) of 51 controls.

The first patient in the UK received the innovative procedure at Barts and The London NHS Trust a year ago.

Commenting on the findings, Professor Jeremy Pearson of the British Heart Foundation said: "This trial opens up a potentially exciting new avenue for the treatment of patients with high blood pressure who do not respond well to current medicines.

"Further studies are needed to see if this invasive procedure will be acceptable to patients and produce long-lasting effects that are safe and reduce future cardiovascular events."

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Professor Graham MacGregor, chairman of UK charity the Blood Pressure Association, said: "This is exciting research which could play a part in tackling the massive issue of high blood pressure, which affects 16 million UK adults and is a major killer through the strokes and heart attacks it causes."

But he said most people would not need to undergo such invasive treatment as, for the majority, high blood pressure can be successfully controlled through prescribed medicines and a healthier lifestyle.

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Ministers &#39;broke midwife pledge&#39;

17 November 2010 Last updated at 03:09 ET <!-- Embedding the video player --> <!-- This is the embedded player component -->

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Cathy Warwick: "The government is not delivering on its pre-election pledge...we are incredibly disappointed"

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The Royal College of Midwives (RCM) has accused the government of backing down on a pre-election pledge to increase midwife numbers in England.

It says mothers and babies will suffer unless the 3,000 extra midwives it says were promised are delivered by 2014.

RCM general secretary Cathy Warwick will tell its annual conference there are too few to cope with a rising birth rate and increasingly complex births.

The Tories said the rise was now not needed as the birth rate was stable.

Speaking ahead of Wednesday's conference in Manchester, Ms Warwick told BBC Radio 5 live ministers had gone back on their word.

Vacant posts

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There is a need for more consultants to deal with the increase in the number of high-risk pregnancies"

End Quote Dr Tony Falconer Royal College of Obstetricians and Gynaecologists

She said: "Just before the election, both the prime minister and the deputy prime minister told us that they would commit to continuing the previous government's promise to give us more midwives.

"We've just done a survey of all the heads of midwifery and they've got vacant posts but they're having difficulty filling them."

The RCM survey of 83 out of 194 heads of midwifery suggested maternity units were already seeing budget and staffing cuts.

Some 30% said their budgets had fallen over the past year, while a third had been asked to reduce staff.

And two-thirds surveyed said they did not have enough midwives to cope with demand.

Meanwhile, the number of live births in England has risen by 19% between 2001 and 2009, to 670,000 a year.

The RCM said births over the same period had become more complex, with obese pregnant women and older or teenage women needing extra support.

The Royal College of Obstetricians and Gynaecologists (RCOG) said maternity services were facing many challenges.

President, Dr Tony Falconer, said: "As well as need for more midwives, there is a need for more consultants to deal with the increase in the number of high-risk pregnancies."

A Conservative Party spokesman said: "The commitment to 3,000 midwives made in opposition was dependent on the birthrate increasing as it has done in the recent past. It was not in the coalition agreement because predictions now suggest the birthrate will be stable over the next few years.

"People can be absolutely clear that our commitment to meet the needs of expectant mothers remains, and we will continue to train new midwives to meet the demands arising from the births."

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