Personalized breast cancer risk assessment could reduce overdiagnosis
Personalized breast cancer screening programs could help women better understand their personal cancer risks and guide providers in recommending mammographic assessments based on these risks.
Such a program was detailed recently at the 13th European Breast Cancer Conference, where Dr. Javier Louro from Hospital del Mar in Barcelona spoke of the numerous benefits of personalized screening programs, citing a reduction in false positives and overdiagnosis, both of which can result in unnecessary and invasive procedures.
“We know about many of the factors that influence breast cancer risk. For example, getting older, having a family history of breast cancer and some types of benign breast disease can all increase the risk. We can’t do much about those risk factors, but we can use this information to predict the risk of breast cancer,” Louro said.
Louro and colleagues tested the efficacy of a personalized screening program using data from the Cancer Registry of Norway (Oslo). This registry includes information from more than 50,000 women who, from 2007 to 2020, took part in BreastScreen Norway—a national screening program that offers women aged 50 to 69 to complete a biennial mammographic screening.
Researchers used information from the registry, including who was and was not diagnosed with breast cancer, in addition to ten different risk factors to develop a model that could estimate individual risks of developing cancer over a period of four years. Some of the risk factors used were age, family history of breast cancer, previous benign breast disease, breast density, body mass index and alcohol consumption.
Overall, the researchers found the average risk to be fairly low, at just 1.10%. Some women had risks as low as 0.22%, while others’ risks were as high as 7.43%.
The results of the study also yielded a surprising revelation pertaining to breast cancer risk factors; experts found that the amount of exercise a woman gets—a factor that is not normally included in risk assessment models—to be more indicative of risk than previously thought.
Commenting on the team’s results, Louro stated that their model could be used for “reducing the harms and increasing the benefits” of mammographic screening. Elaborating further, he noted that this might mean that women with very low risk could be offered routine mammographic screening every three to four years, while women with increased risks could undergo yearly mammograms or more detailed yearly assessments, such as breast MRI.
However, Louro did note that the suggested strategies are still “theoretical,” and that their effectiveness warrants further study, including analyses consisting of a wider range of populations.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.