A major pan-European study showed that survival rates in England and Scotland were lower than in other European countries in the 1980s. 6 This was probably due, at least in part, to the fact that British patients tended to have more advanced disease at the time of diagnosis. It is not yet known whether the discrepancy in outcomes has been reduced in the period since this study was carried out. Risk factors The causes of breast cancer are complex. It has been suggested that up to 10% of patients may have an inherited predisposition to the disease. 7 This can arise from mutations in particular genes; two have been identified (BRCA1 and.
