Current Strategies to Reducing Interval Breast Cancers: A Systematic Review

Area of Science:

• Oncology
• Radiology
• Public Health

Background:

• Interval breast cancers (IBCs) are detected between mammograms, impacting screening program effectiveness.
• IBC prognosis mirrors unscreened symptomatic cancers, making IBC rates a key performance indicator.
• Reducing IBC rates is crucial for improving breast cancer detection and patient outcomes.

Purpose of the Study:

• To systematically review and consolidate literature on strategies for reducing interval breast cancer (IBC) rates.
• To identify effective screening modalities and interventions for lowering IBC incidence.
• To inform the development of optimized breast cancer screening protocols.

Main Methods:

• Systematic review following PRISMA guidelines.
• Searched three databases from inception to October 29, 2023.
• Included keywords: "interval breast cancer", "mammogram", "tomosynthesis", "screening".

Main Results:

• 32 articles were included in the review.
• Digital breast tomosynthesis (DBT) was discussed in 14 studies as an alternative to mammograms.
• Artificial intelligence (AI), supplemental ultrasonography (US), adjusted screening intervals, and tamoxifen use were also evaluated.

Conclusions:

• Early detection through advanced techniques like DBT and AI can alter the trajectory of IBCs.
• Adjusting screening intervals and addressing modifiable risk factors are key strategies.
• The goal is to develop cost-effective and accessible screening protocols for diverse populations.