1,500 women missed out on annual checks despite ‘very high’ breast cancer risk

Nearly 1,500 women who were not referred for annual MRI checks despite being at “very high risk of breast cancer” are to be offered scans within the next three months, Health Secretary Victoria Atkins confirmed.

NHS England said there had been a “failure to refer” 1,487 women who received radiotherapy treatment above the waist to treat Hodgkin lymphoma between 1962 to 2003.

In a ministerial statement, health minister Andrew Stephenson said a number of women who were eligible for annual testing were not informed “due to variable referral processes”.

NHS England said it is taking the issue “very seriously” and it will do “everything possible to ensure these women will be offered appropriate screening, at speed, in a compassionate and respectful way which is tailored to their clinical history”.

The Secretary of State told the Commons that letters sent by NHS England on Monday would address the “historic issue” of women being left off the Very High Risk pathway.

Ms Atkins said: “This letter addresses a historic issue where women who received radiotherapy above the waste to treat Hodgkin lymphoma and therefore were at higher risk of breast cancer were not given annual checks.

“The NHS wrote to the 1,487 women affected yesterday in order to inform them, we expect all women to be offered a scan within the next three months, and NHS England has established a helpline and briefed GPs and relevant charities.

“The vast majority of this group of women will have already been receiving screening on a three-yearly basis, but of course NHS England wants to ensure they receive annual tests in line with the clinical guidance.”

In 2000, research showed women who had received radiotherapy treatment to their chest for Hodgkin lymphoma were at higher risk of developing breast cancer and, in 2003, clinicians were asked to contact both previous and current patients to refer them for annual checks.

But it was not until September 2023 that details of a missed group were shared with NHS England and ministers were notified in February 2024.

In a letter addressed to Ms Atkins, NHS England said: “We are writing to update you on the issue that we have identified. This is in respect of the failure to refer for annual MRI surveillance a number of women who have been treated with radiotherapy to their chest for Hodgkin lymphoma.

“Women who have had this treatment between the ages of 10 and 35 are at higher risk of developing breast cancer than the general population and should be referred to the very high risk service within the Breast Screening Programme.

“A cohort of women who received radiotherapy between 1962 and 2003 were initially identified as a potential at risk group in 2003, and now a sub group of those women, 1,487 in total as of February 2024, have been identified as not currently receiving annual MRI testing who should be.

“NHS England is taking this very seriously and the NHS will do everything possible to ensure these women will be offered appropriate screening, at speed, in a compassionate and respectful way which is tailored to their clinical history.”

A Breast Screening after Radiotherapy Dataset (BARD) was set up in 2021, which uses national datasets and undertakes checks with treating centres with the aim to ensure all women at increased risk of breast cancer following radiotherapy are referred to the NHS Breast Screening Programme in line with national guidelines.

Prior to 2021, NHS England said its screening services relied on referrals from individual genetic services, family history clinics and radiotherapy centres.

NHS England said the establishment of BARD and the Very High Risk pathway enabled them to identify the missed group of women.

In a ministerial statement, Mr Stephenson said: “NHS England wrote to a group of women who are at Very High Risk of breast cancer who have been eligible for annual MRI checks, but who may not have been routinely referred to the annual tests recommended in NHS guidance.”

He added: “A number of women who were eligible for more regular ‘annual’ testing did not receive it. This was due to variable referral processes.”

NHS national director for vaccinations and screening Steve Russell said: “The NHS is contacting 1,487 women at increased risk of breast cancer due to having radiotherapy involving their chest for Hodgkin lymphoma, who may not yet have been offered additional annual screening.  
 
“While most of these women are already enrolled in the NHS Breast Screening Programme for regular mammograms, all women affected will now be offered support and invited for an annual MRI, and in most cases an annual mammogram, as soon as possible – the NHS will aim to complete this within three months. 
 
“We would like to extend our sincere apologies to those affected for any additional worry this may have caused – anyone who has had prior radiotherapy to their chest for the treatment of Hodgkin lymphoma and who is concerned they have not been invited for an annual MRI can call our dedicated helpline for support and further information.”