A study looking at improving the risk assessment of breast cancer in young women (BCAN-RAY)

Cancer type:

Breast cancer

Status:

Open

Phase:

Phase 1

This study is looking at the density of breast tissue in young women. The researchers want to find out if this has a strong influence on the risk of these women getting breast cancer. 

It is open to young women who live in the Greater Manchester area and Cheshire. 

More about this trial

Doctors use a mammogram to find out how dense the breast tissue is. Breasts are made up of lots of tiny glands that produce milk. This is glandular tissue and contains many more breast cells than other breast tissue such as fatty tissue. The more breast cells there are the denser the breast.  

We know that the density of the breast tissue is a risk factor in developing breast cancer. The denser the tissue the stronger the risk is. This is especially so for women over the age of 40. 

For younger women it isn’t known how strong a risk factor dense breast tissue is. In this study researchers are looking at the density of breast tissue in women between the ages of 30 and 39 years old. 

They want to look at mammograms from women who have had breast cancer and women who haven’t had breast cancer.  

As part of the study the team ask for spit (saliva) samples to look for gene Open a glossary item changes (mutations Open a glossary item) that are known to increase your risk of getting breast cancer. 

If you don’t have breast cancer having these gene changes doesn’t mean you will definitely develop breast cancer. 

The aims of this study are to find out:

  • how strong a risk factor dense breast tissue is for young women
  • how to include this when working out their risk of breast cancer 
  • the most acceptable way to tell young women who don’t have breast cancer about their risk of getting breast cancer

Who can enter

The following bullet points are a summary of the entry conditions for this study. Talk to your doctor or the study team if you are unsure about any of these. They will be able to advise you. 

Only women from the Greater Manchester and Cheshire area can take part in this study. If your GP practice is part of the study you will get an invitation letter from them if you might be able to take part.

 

There are 2 groups in this study:

  • Case group
  • Control group

Who can take part

Case group
You may be able to join if have been diagnosed with breast cancer.

Control group 
You may be able to join if don’t have breast cancer. You need to be willing to receive information about your risk of breast cancer. 

All of the following also need to apply, you:

  • were born female  
  • are between 30 and 39 years old
  • are able to understand written English

There are sub studies in the main study. A member of the study team will talk to you about them if you might be able to join any of them.

Who can’t take part

Case group
You cannot join the Case group if you:

  • have breast implants, had breast enlargement surgery or breast reduction surgery before you were diagnosed with breast cancer
  • have had treatment for early breast cancer such as chemotherapy, hormone therapy, targeted therapy or trastuzumab
  • were diagnosed with another cancer apart from non melanoma skin cancer Open a glossary item before you were diagnosed with breast cancer
  • are pregnant 

Control group
You cannot join the Control group if you:

  • have had breast cancer
  • have breast implants or had breast enlargement surgery
  • have had both breasts removed (a double mastectomy)
  • have been diagnosed with another cancer apart from non melanoma skin cancer Open a glossary item
  • have any other medical condition or mental health problem that your doctor thinks could affect you taking part
  • are pregnant, breastfeeding or have stopped breastfeeding less than 6 months ago

You cannot join if any of these apply. You:

  • were born male
  • have a known change in a gene such as BRCA1 Open a glossary item or BRCA2 Open a glossary item that puts you at a moderate to high risk of developing breast cancer
  • have a strong family history Open a glossary item of breast cancer. You can ask your doctor about this. 

Trial design

There are 2 groups in this study.

Case group
The team need 250 women to join this group. 

At one of your breast cancer clinic appointments a member of the team will talk to you about the study. If you want to take part they’ll ask you to complete a questionnaire. The questions ask about:

  • whether there is a family member with a diagnosis of breast cancer or ovarian cancer
  • your age when you started having periods
  • whether you have been pregnant
  • when you were diagnosed 
  • whether you used hormonal contraception such as the pill
  • whether you have used hormone replacement therapy (HRT)

They take your height and weight. This is to work out your body mass index Open a glossary item (BMI). This is because your breast density is connected to your BMI. 

You give a spit (saliva) sample. The team member will tell you how to do this. They will use this sample to look at your genes Open a glossary item.

The team will also look at your medical records and previous mammograms. 

Control group
The team need 750 women to join this group.

You get a letter inviting you to take part in the study from your GP. The letter contains an information sheet about the study. After reading the information if you want to take part there is a web based application (app) you need to go on to. The team include the internet address for the app in the information.

When you are on the app you need to tick a box before proceeding. By doing this you give your consent for the study team to collect personal information. If you don’t want to give the team your personal information then you shouldn’t tick the box or go any further. 

After ticking the box you:

  • enter the unique identification number in the letter and your date of birth
  • enter your email address. You also create a password in case you need to leave the app and come back later. 
  • answer a few questions. By answering these you give your consent to take part in the study.
  • fill in a questionnaire about your risk of getting breast cancer. The team will estimate what your risk of getting breast cancer is from the answers you give. You may not be able to answer all the questions but the more information the team have the better they can assess your risk.

There is a phone number in the letter to contact the study team if you have any problems with the app or with answering any of the questions.
 
Family history of cancer
Some of the questions will ask whether any member of your family has or had cancer. The team use these answers to work out whether you might have a strong family history. Having a strong family history of breast cancer means you might be at a higher risk of developing breast cancer. 

If you have a strong family history
You cannot continue in the study if you have a strong family history of cancer. The study team will ask your permission to send a letter to your GP. This will ask them to refer you to the family history clinic to further assess your risk of developing breast cancer. 

If you don’t have a strong family history
You can continue in the study if you don’t have a strong family history of cancer. The team will make an appointment to see you.

You fill in an online questionnaire before the appointment. The questions ask about your:

  • health and wellbeing
  • knowledge, understanding and awareness of breast cancer risk

The team ask whether they can interview you about taking part in the study. This will be at a time and place convenient to you. You don’t have to agree to do this. You can still take part in the main study.

Seeing the study team
Before going to the appointment the team will ask you to give a spit (saliva) sample. You are sent the tube and instructions on how to do the sample in the post. You take the sample with you when you go to the appointment.  

The team ask you some questions. You have a low dose mammogram. 

They ask if you would like to take part in the cervical self sampling study. For this you take a sample from the cervix Open a glossary item which is connected to the vagina. If you are happy to do this the team will provide a private room and tell you how to do it. You take the sample yourself while at the appointment with an easy to use sampling brush and then hand this over to the study team. You don’t have to agree to give this sample.

After the appointment
The team analyse your sample and mammogram to work out your breast cancer risk. You receive a letter based on whether your risk is average or is above average. 

Average risk
If your risk is about average the letter is about healthy living and breast awareness. 

Above average risk
If your risk is above average in the letter the team will ask if you’d like an appointment at the Breast Cancer Family History Risk and Prevention Clinic at The Nightingale Centre, Manchester. This is to review your risk in more detail and to discuss any breast cancer prevention and screening that you may be suitable for you. This appointment is not a part of the study itself but part of NHS care. So they will need your permission to ask your GP to arrange this. 

Control group
You fill in questionnaires 6 weeks and 24 weeks after receiving the letter about your risk from the study team. One is about your:

  • health and wellbeing
  • knowledge, understanding and awareness of breast cancer risk

You are also asked about:

  • the risk information you received and how satisfied you were with it
  • your decision to take part in the study

The team sends out the link by email or mail for you to access these questionnaires. They will send a prompting email or letter if you haven’t completed them within 2 weeks. 

Hospital visits

For the Case group there are no extra hospital visits. 

For the Control group there is 1 hospital visit. 

Side effects

It might be upsetting to find out you have a gene change (mutation) that gives you a high risk of getting breast cancer. A member of the study team will talk to you about your risk and how it might affect you and your family. 

Control group – low dose mammogram
A mammogram uses radiation and this might increase your risk of getting cancer. The mammogram you have uses a low dose of radiation and the risk of it causing cancer is very small. The amount of radiation you get is about the same as 4 to 8 days of radiation that occurs naturally (background radiation) such as sunlight. 

A low dose mammogram won’t pick up cancer in your breast. It is important to see your doctor if you think you might have breast cancer. 

We have information about breast cancer symptoms and having a mammogram
 

Location

Crewe
Manchester
Wigan

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Sacha Howell

Supported by

Manchester University Hospital NHS Foundation Trust
CRUK International Alliance for Cancer Early Detection (ACED)
The Christie Charity

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

18921

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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