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Personalized breast cancer screening program could improve survival

"This research shows how we might be able to identify people with a high risk of breast cancer, but equally how we could identify those with a low risk. So it's an important step toward personalized screening."

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By Mark Waghorn via SWNS

A personalized breast cancer screening program that could improve survival and reduce overdiagnosis has been unveiled by scientists.

It predicts a woman's risk of developing the disease based on ten factors ranging from lifestyle to family history.

The technique is aimed at remedying long-running concerns that mammograms are prone to false alarms and missed cases.

Project leader Dr. Javier Louro, of Hospital del Mar, Barcelona, said: "Our model might be considered a key for designing personalized screening aimed at reducing the harms and increasing the benefits of mammographic screening.

"For example, someone with low risk, might be offered screening with standard mammography every three or four years instead of two years.

"Someone with medium risk might be offered screening with advanced 3D mammography every two years, while those at a high risk might be offered a new screening test with mammography or MRI every year.

"All of these strategies are still theoretical and should be studied with regard to their effectiveness."

The Spanish team took into account age, family history or previous benign disease, breast density, BMI (body mass index|) and alcohol intake.

They compared these influences in those with and without a diagnosis to assess the impact of each - and test their accuracy

Chances of developing a breast tumor over a period of four years ranged from 0.22 to 7.43 percent.

The system presented at the European Breast Cancer Conference in Barcelona showed average risk was 1.1 percent.

It also indicated some factors are more important than thought. This included the protective effect of exercise - not usually included in risk prediction models.

Louro and colleagues used data from around 50,000 participants in BreastScreen Norway collected between 2007 and 2020.

The national program invites all women aged 50-69 to have a mammogram every two years.

They can lead to false positives when further tests show there is no cancer or women being treated for a slow growing tumor that would not spread during their lifetime.

"We have successfully developed and validated a model to estimate breast cancer risk in women participating in BreastScreen Norway, the national breast cancer screening program in Norway," Louro said.

"Several breast cancer risk prediction models have been created, but we believe this is one of the first models designed to guide breast screening strategies over a person's lifetime using real data from a screening program.

"It is also the first model developed using data from BreastScreen Norway."

Around 2.3 million people worldwide are diagnosed with breast cancer each year. The NHS screening program offers three yearly mammograms to over 50s.

Meeting co chair Dr. Laura Biganzoli, of Santo Stefano Hospital, Prato, Italy, who was not involved in the research, said: "We know breast screening programs are beneficial.

"But we also know some people will experience potential harms caused by false positives or overdiagnosis.

"A screening program tailored to each person’s risk could reduce these harms and increase the benefits.

"This research shows how we might be able to identify people with a high risk of breast cancer, but equally how we could identify those with a low risk. So it's an important step toward personalized screening."

Breast cancers kill 685,000 women annually - including around 11,500 in the UK. Screening ensures they are discovered as early as possible.

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