Study finds risk-based approach to breast cancer screening is better

New Delhi : An individualised approach to breast cancer screening that assesses patients’ risk, rather than annual mammograms, can lower the chance of more advanced cancers, while still safely matching people to the amount of screening they need, according to a study.

The findings, by the University of California, San Francisco (UCSF), based on a study of 46,000 US women, support shifting the approach to screening from one that is based on age alone to one that starts with comprehensive risk assessment to determine each woman’s optimal screening schedule.

“The findings should transform clinical guidelines for breast cancer screening and alter clinical practice,” said Laura J. Esserman, director of the UCSF Breast Care Center.

“The personalised approach begins with risk assessment, incorporating genetic, biological, and lifestyle factors, which can then guide effective prevention strategies,” Esserman added.

Breast cancer is the most common cancer in women, accounting for an estimated 2.3 million cases and 670,000 deaths globally.

For decades, screening assumed all women have the same risk, and guidelines were based largely on age, despite strong evidence that individual risk varies widely.

The new study, published in JAMA, compared the standard annual mammogram with an approach based on individual risk.

The results showed that the risk-based screening approach did not increase the frequency of higher-stage cancers.

“Shifting resources from lower-risk women to higher-risk women is an efficient, effective approach to screening for and preventing breast cancer,” said co-author Jeffrey A. Tice, Professor of Medicine at UCSF.

Importantly, the study found that 30 per cent of the women who tested positive for a genetic variant that increased their risk of breast cancer did not report a family history of breast cancer. Under current clinical guidelines, these people would not normally be offered genetic testing.