Warning on 'unnecessary' breast X-rays

DOCTORS are being advised not to send women under 50 for breast X- rays simply because they have started the menopause or because they are taking hormone replacement therapy.

For the first time, guidelines from the Royal College of Radiologists aimed at stopping unnecessary X-rays and the deaths that eventually result from them, have included a section on mammography (breast cancer screening). Even when a family doctor has found a lump, the guidelines say that the patient should be referred first to a breast surgeon or specialist clinic.

A joint report from the college and the National Radiological Protection Board 30 months ago stated that unnecessary X-rays caused between 100 and 250 deaths from cancer every year, and said that the number of X- rays could be halved.

But the mammography advice is controversial; X-rays in this younger group do not have any impact on the rate of deaths from breast cancer, which is rare in women under 50.

On the other hand, many doctors who favour mammography for menopausal patients before they start hormone replacement therapy say it benefits the individual in whom early breast cancer is detected. Women over 50 are automatically enrolled into the national screening programme.

Dr Stuart Field, dean of the college's faculty of clinical radiology, said that there was a fierce debate over mammography for the under-50s, 'but, given the current evidence, we are advising against it'.