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Screening Programs for Breast Cancer: Toward Individualized, Risk-Adapted Strategies of Early Detection

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Breast Cancer Research and Treatment

Part of the book series: Cancer Treatment and Research ((CTAR,volume 188))

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Abstract

Early detection of breast cancer (BC) comprises two approaches: screening of asymptomatic women in a specified target population at risk (usually a target age range for women at average risk), and early diagnosis for women with BC signs and symptoms. Screening for BC is a key health intervention for early detection. While population-based screening programs have been implemented for age-selected women, the pivotal clinical trials have not addressed the global utility nor the improvement of screening performance by utilizing more refined parameters for patient eligibility, such as individualized risk stratification. In addition, with the exception of the subset of women known to carry germline pathogenetic mutations in (high- or moderately-penetrant) cancer predisposition genes, such as BRCA1 and BRCA2, there has been less success in outreach and service provision for the unaffected relatives of women found to carry a high-risk mutation (i.e., “cascade testing”) as it is in these individuals for whom such actionable information can result in cancers (and/or cancer deaths) being averted. Moreover, even in the absence of clinical cancer genetics services, as is the case for the immediate and at least near-term in most countries globally, the capacity to stratify the risk of an individual to develop BC has existed for many years, is available for free online at various sites/platforms, and is increasingly being validated for non-Caucasian populations. Ultimately, a precision approach to BC screening is largely missing. In the present chapter, we aim to address the concept of risk-adapted screening of BC, in multiple facets, and understand if there is a value in the implementation of adapted screening strategies in selected women, outside the established screening prescriptions, in the terms of age-range, screening modality and schedules of imaging.

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Authors and Affiliations

  1. Division of New Drug Development for Innovative Therapies, European Institute of Oncology IRCCS, Milan, Italy

    Dario Trapani, Pamela Trillo Aliaga, Liliana Ascione, Pier Paolo Maria Berton Giachetti & Giuseppe Curigliano

  2. Department of Oncology, Geneva University Hospitals, Geneva, Switzerland

    Josè Sandoval

  3. Unit of Population Epidemiology, Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland

    Josè Sandoval

  4. Department of Oncology and Hematology, University of Milan, Milan, Italy

    Pamela Trillo Aliaga, Liliana Ascione, Pier Paolo Maria Berton Giachetti & Giuseppe Curigliano

  5. International Agency for Research On Cancer, Lyon, France

    Ophira Ginsburg

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  1. Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco

    Ouissam Al Jarroudi

  2. Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco

    Khalid El Bairi

  3. Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, Milan, Italy

    Giuseppe Curigliano

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Trapani, D. et al. (2023). Screening Programs for Breast Cancer: Toward Individualized, Risk-Adapted Strategies of Early Detection. In: Al Jarroudi, O., El Bairi, K., Curigliano, G. (eds) Breast Cancer Research and Treatment. Cancer Treatment and Research, vol 188. Springer, Cham. https://doi.org/10.1007/978-3-031-33602-7_3

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