Personalized Screening for Breast Cancer: Rationale, Present Practices, and Future Directions

Area of Science:

• Oncology
• Preventive Medicine
• Clinical Trials

Background:

• Population-based breast cancer (BC) screening significantly reduces mortality.
• Current screening practices typically use a one-size-fits-all approach, irrespective of individual BC risk.
• This approach has limitations and may not be optimal for all women.

Purpose of the Study:

• To review current population-based BC screening practices and their shortcomings.
• To discuss BC risk factors and existing risk assessment models.
• To present ongoing clinical trials investigating personalized, risk-adapted BC screening strategies.

Main Methods:

• Literature review of current BC screening practices.
• Identification and analysis of three large-scale, randomized controlled clinical trials (WISDOM, MyPEBS, TBST) through MEDLINE and ClinicalTrials.gov.
• Comparison of standard screening versus personalized risk-adapted screening approaches within these trials.

Main Results:

• Multiple ongoing trials are comparing standard population-based screening with personalized, risk-adapted screening.
• These trials utilize diverse risk stratification methods and screening modalities.
• The primary goal is to determine if personalized screening can achieve comparable advanced-stage BC detection rates to current methods.

Conclusions:

• Personalized risk-adapted screening holds the potential to replace current population-based breast cancer screening.
• Results from ongoing trials are anticipated to inform future screening guidelines.
• The findings may lead to safer and more effective breast cancer early detection strategies.