A new study from Australia found that 41% of screen-detected breast cancers occurred in women with no recorded risk factors.
Globally and in Australia, there’s been interest in risk-stratified breast screening to improve benefits while reducing screening-associated harms.Increasing screening frequency or more sensitive imaging would be used for women at increased risk while lowering screening frequency for those with lower risks.However, the screening outcomes for women who don’t have any specific breast cancer risk factors is unknown. They are presumed to have the same or lower than the general population’s risk.
A team led by Dr Naomi Noguchi from the University of Sydney in Australia examined data from the BreastScreen Western Australia program to resolve this issue. The study included 1,026,137 mammography screens from 323,082 women aged 40 years or greater from July 2007 to June 2017.In the program, women were eligible for free mammograms every two years.
The research team saw that 2,347 (40.9%) of the 566,948 screening exams in women without recorded risk factors had breast cancer. Although the screen-detected cancer detection (50/10,000) and inter-screen interval cancer (7.9/10,000) rates were lower than screening exams in women with at least one risk factor (83/10,000 and 12.2/10,000), these were not low enough to justify less screening. Moreover, women with no risk factors who delayed screens had more node-positive cancers (26.1% vs 20.7%).
Overall, the study showed that screening participants without recorded breast cancer risk factors had a large proportion of screen-detected cancers. The study authors concluded that: ‘Our findings may not align with the proposed concept of de-intensify screening in those deemed at lower risk based on conventional risk factors, or at least do not justify less frequent screening in women with none of the risk factors routinely recorded in screening services.’
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Source: The Breast