Breast cancer: is the current screening appropriate?The RISCAM study

Background: Early diagnosis is key to improving outcomes of breast cancer cases. However, controversy remains regarding the lower age limits and the non-personalized nature of screening programs. The main objectives of this study are to investigate the relevance of defining a new lower age limit for breast cancer screening, characterize risk factors not included in the Tyrer-Cuzick™ risk assessment calculator, and explore the feasibility of personalizing screening. Methods: This is an observational case-control study. The case group included 64 women with a breast cancer diagnosis. Breast cancer incidence was calculated by age group. Participants were characterized with respect to three cancer risk factors, namely smoking habits, alcohol consumption, and breastfeeding. A risk score was assigned to each woman through the Tyrer-Cuzick™ risk model, and patients were subsequently stratified into several risk groups. Finally, the relationships between intermediate to high-risk groups and breast cancer development were studied. Results: We found no statistically significant differences between breast cancer incidence in women aged 40 to 49 vs. 50 to 69, in the health units studied. There was no statistically significant link between the 3 studied risk factors and breast cancer development. We observed a statistically significant relationship between intermediate to high-risk scores and the development of breast cancer (odds ratio (OR) 10.0 with p = 0.0009). Conclusions: These results support initiating screening from the age of 40 and adopting a patient-centered model, provided that a screening tool with high sensitivity becomes available.

Breast cancer; Screening; Early diagnosis; Risk assessment; Medical oncology

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