Genetics

Simple saliva test for breast cancer could save thousands of under-50s

A saliva test which identifies almost half of women who will get breast cancer in the next decade could save the lives of thousands of under-50s.

The test has been championed by television presenter Julia Bradbury, who was diagnosed with breast cancer aged 51, and has been welcomed as ‘promising’ new research by Health Secretary Sajid Javid.

It could be particularly valuable to identify under-50s at higher genetic risk of breast cancer, who can not currently get mammograms on the NHS.

A major study on the saliva test looked at almost 2,500 women at risk of developing breast cancer. Among these women, who were followed up for an average of almost ten years, 644 got breast cancer.

The saliva test is expected to cost around £ 250 on the NHS, while breast cancer treatment can cost tens of thousands of pounds [File photo]

The saliva test is expected to cost around £ 250 on the NHS, while breast cancer treatment can cost tens of thousands of pounds [File photo]

The test, used alongside the standard medical and life history information, and a measure of women’s breast density, accurately predicted a higher risk of breast cancer in just under 50 per cent of those who got it.

Professor Gareth Evans, who led the study from Manchester University, said: ‘If all these women took drugs to prevent breast cancer, that could prevent a quarter of breast cancer cases and potentially save the lives of 2,000 women a year. If young women at high risk were offered annual mammograms, that could save hundreds more more a year.

‘It is particularly important for women under 50, who make up one in five cases of breast cancer.’

Researchers want the one-off genetic test to be rolled out to women at around the age of 30, well before they become eligible for mammograms aged 50.

The saliva test is expected to cost around £ 250 on the NHS, while breast cancer treatment can cost tens of thousands of pounds.

Mr Javid said the findings are ‘promising’, adding: ‘We are constantly monitoring innovative research like this to help inform our approach and get patients treated quicker.’ Currently women under 50 can typically only get a genetic test on the NHS if a family member has a faulty gene linked to breast cancer, or if they have a strong family history of the disease in younger women.

It has been welcomed as 'promoting' new research by Health Secretary Sajid Javid.  It could be particularly valuable to identify under-50s at higher genetic risk of breast cancer, who can not currently get mammograms on the NHS

It has been welcomed as ‘promoting’ new research by Health Secretary Sajid Javid. It could be particularly valuable to identify under-50s at higher genetic risk of breast cancer, who can not currently get mammograms on the NHS

The new study is the first to look at this test, and a saliva test looking for more than 300 genetic differences, plus the two measures already available on the NHS – breast density and risk factors such as weight and family history.

Researchers found women with a ‘moderate or high risk’ of breast cancer made up 48 per cent of those who developed ‘growing’ breast cancers, categorized at stage two or higher by doctors.

But almost one in five women was found to be low-risk for breast cancer, meaning they had a well under 2 per cent chance of developing it in the next decade.

It means not only might higher-risk women need more screening, but almost one in five low-risk women could need less frequent mammograms.

The study results, published in the journal Genetics in Medicine, found around one in 50 women with breast cancer had mutations in the BRCA1 or BRCA2 genes which increased their risk of the disease. Of the nine women with breast cancer and a BRCA mutation in the study, only three would have been able to find this out through the NHS under current rules.

But the study authors say BRCA mutations are so uncommon that it is important to look at hundreds of other genetic variations too.

Individually they carry a lower risk of breast cancer together they can help to significantly predict if women will get breast cancer.

In the study, four in ten women were found either to have the highest risk, a moderate or high risk or the lowest risk of breast cancer. These are described as ‘actionable’ categories. Some of the women with a higher risk have opted to start drugs likely to reduce their risk.

The UK National Screening Committee, which decides whether genetic testing should be available to all women, is looking at the results of the saliva test.

Dr Kotryna Temcinaite, of Breast Cancer Now, said: ‘Every year 55,000 women and 370 men are diagnosed with breast cancer in the UK. Early detection can stop people dying from breast cancer, which is why we need research like this to understand how a more tailored approach to breast screening could work. ‘

Countryfile Julia: It may have spared me a mastectomy

A GENETIC test for breast cancer should be rolled out to all women on the NHS, television presenter Julia Bradbury has said.

The mother of three and former Countryfile presenter had a mastectomy to remove her left breast after an ultrasound scan revealed a two-inch tumor.

She said: ‘If I could have had a saliva test which showed I had an increased risk of breast cancer, that could have led to my cancer being detected earlier, and could have saved my left breast.

‘I am such a champion of genetic tests for women and men because cancer treatments like mastectomies, radiation and chemotherapy are brutal and harsh.’

The mother of three and former Countryfile presenter had a mastectomy to remove her left breast after an ultrasound scan revealed a two-inch tumor

The mother of three and former Countryfile presenter had a mastectomy to remove her left breast after an ultrasound scan revealed a two-inch tumor

Miss Bradbury – who recently made the documentary Breast Cancer and Me – became eligible for a mammogram on the NHS last July.

Two mammograms came back clear, but a further ultrasound revealed a ‘shadow’ on a scan. She used a saliva test, looking for genetic variations which indicate her risk, to decide against having a double mastectomy.

Professor Gareth Evans, who works at Manchester University NHS Foundation Trust and offered Miss Bradbury the test, said: ‘I really believe that if Julia could have been given this genetic test, and doctors used the results, she would have been screened from the age of 40.

‘That could have meant her breast cancer being picked up much sooner by a mammogram. This could apply to as many as one in eight women with no family history of breast cancer. ‘

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