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Updated 'Breast screening referral form for women at very high risk' following an update in the breast screening IT system.

Increased Breakage: This is not technically hair loss but can look very similar. Fragile hair can snap along the hair shaft resulting in less growth. Although it’s not a type of hair loss, it can be seen alongside other types and requires strengthening treatments.Women who have previously received total body irradiation are at an elevated risk of breast cancer in the years following treatment. However, there is insufficient evidence to show that the risk reaches the threshold to qualify this cohort of women for screening in the very high risk programme.

To access this, confirmation is required from the genetics service that a first degree relative carries a germline pathogenic variant. After the age of 50 a previously untested woman will be returned to the routine screening programme. Any women who are newly referred into the VHR programme after the age of 50 should have both MRI and mammography performed at the initial screen and a breast density review undertaken at this point to assess whether MRI is required at subsequent screens. If breast density is not initially classified as BI-RADS A, annual review should take place thereafter. Baseline MRIs for women considering risk-reducing surgery the treating clinician (surgeon or oncologist) - for cancer patients found to carry a genetic mutation that meets the eligibility criteria for very high risk screeningUse a silk turban: silk turbans are great to prevent pulling when you’re sleeping as they prevent resistance that can lead to fall out.

On receipt, each referral must be transferred to the named high risk coordinators or director of breast screening without delay and be reviewed to make sure the inclusion criteria have been evidenced. This review must be completed by a consultant radiologist, consultant practitioner or breast clinician experienced in the full range of triple assessment. In the rare occurrence where women fulfill more than one risk criteria for very high risk screening (for example, BRCA1 gene mutation and previous radiotherapy to breast tissue when aged 15), the lead clinician should make an assessment regarding the most appropriate surveillance protocol. If recall is within 6 weeks of the original assessment then it should be part of the same episode. If recall is after 6 weeks, it should be logged on NBSS as a short-term recall ( STR) episode. The default period for VHR short-term recalls is 3 months following assessment. No more than 6 months should elapse between previous screening assessment appointments and the STR episode.if the complete VHR protocol includes MRI only, her NTDD moves to 12 months from the date of the original screen (for MRI)