Screening tests for breast cancer are mature to change. We must assess the risk of a woman – not only her age

Australia Breast screen The program offers women regular mammograms (X -rays) based on their age. And this screening for breast cancer Saves life.

But a lot has changed since the introduction of the program in the early 1990s. The technology has developed, just like the knowledge which groups of women can be more exposed to breast cancer. So, as we examine women for breast cancer, it must adapt.

IN recent articleWe proposed a fundamental departure from an age -based approach to a screening program that takes into account the risk of breast cancer by women.

We claim that we could save more life if the tests and schedules of screening were personalized on the basis of someone’s risk.

We do not know exactly how it can work in practice. We have to consult with all the involved pages, including healthcare employees, the government and women, and we must start Australian attempts.

But here is why we have to think about how we study breast cancer in Australia.

Why does the breast test have to change?

The Australian thoracic screen was introduced in 1991 And offers women regular mammograms based on their age. Women at the age of 50-74 they are targetedBut screening is available at the age of 40.

The program is crucial for Australia’s efforts to reduce the burden of breast cancer, ensuring Over a million screens Every year.

Women attending the breast screen reduce the risk of death due to breast cancer by Average 49%.

Breast examination saves life because it has a great impact Find breast cancer earlybefore they spread to other parts of the body.

Still 75,000 Australian women He is expected to die because of breast cancer over the next 20 years if we continue the current approach to screening and breast cancer management.

Who is exposed to high risk and how to get the best of them?

International evidence confirms that this is possible Identify women’s groups with greater risk of breast cancer. These include:

• Women with denser breasts (in which the chest is more glandular and fibrous tissue than fat tissue) develop breast cancer more often, and their cancer is more hard to find on standard mammogram

• Women whose mother, sisters, grandmother or aunt had breast or ovarian cancer, especially if there are many relatives and cancer occurred In youth

• Women who have been found that they have genetic mutations that lead to a higher risk of breast cancer (including women with many moderate risk mutations, which indicates so -called A Polygenic risk result).

Women in these and other high -risk groups can justify a different form of screening. This may include screening tests from a younger age, more often examining and offering more Sensitive tests such as digital tomosynthesis of breast (3D mammography version), MRI or mammography enhanced with contrast (a type of mammography that uses a dye to emphasize cancer changes).

But we don’t know yet:

• How best to identify women with a higher risk

• Which screening tests should be offered, how often and to whom

• How to support a risk screening program

• How to deliver it in a profitable and fair way.

Road ahead of us

We worked on this for the Council of Australia Cancer, under Rosa Piers project.

This project financed federally estimated and compared the expected results and costs of a number of screening scenarios.

In each scenario, we estimated the benefits (saving life or less intensive treatment) and damage (excessive diagnosis and test indicators in withdrawn women for further examination after the test test test, which do not have breast cancer).

WITH 160 potential screening scenarios We modeled, on a tiny list of 19, which brought the best results for women and were the most profitable. Compact scenarios tended to cover screening technologies for higher risk women or screening technologies other than mammography for all women.

For example, in our estimates, not a change in the target age range or screening ranges, but offering a more sensitive screening test of 20% of women recognized as the highest risk would save 113 people in ten years.

Alternatively, starting a targeted screening tests at the age of 40 and offering a more sensitive screening test annually 20% of women with the highest risk and a three -year test (current type) at 30% of women at the lowest risk, would save 849 lives in ten years.

However, it was expected that less recurrent lower risk group screening would lead to a slight escalate in death due to breast cancer in this group.

We also presented 25 recommendations Take action and set a five -year road map, how to get there. This includes:

• A enormous -scale test to find out what is feasible, effective and inexpensive in Australia

• Making up women at a higher risk in various parts of Australia receive appropriate options regardless of where they live and who they see

• better data collection and reporting To support risk -based screening

• Testing how we assess women in terms of risk of breast cancer, including whether these assessments act as intended and sense for women from a number of environments

• Clinical tests of screening technology to determine the best delivery models and related costs

• Continuous commitment to groups, including women, health care workers and the government.

Review of screening breast cancer soon

Federal Health Minister Mark Butler said a review thoracic program Consider our recommendations. The results of this review are expected soon.

We are not ourselves, calling for a transition towards breast cancer screening. This is supported by national AND international Reports to the government, Politics information documents and Network breast cancer Australia.

We provided a road map based on evidence towards better screening for breast cancer. The time has come to get involved in this journey.

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We recognize Louiza Velentzis from the center of Daffodil and Paul Grogan and Deborah Bateson from the University of Sydney, who are co -author of the article mentioned in this article.