scholarly journals Personalized Risk Assessment for Prevention and Early Detection of Breast Cancer: Integration and Implementation (PERSPECTIVE I&I)

2021 ◽  
Vol 11 (6) ◽  
pp. 511
Author(s):  
Jennifer D. Brooks ◽  
Hermann H. Nabi ◽  
Irene L. Andrulis ◽  
Antonis C. Antoniou ◽  
Jocelyne Chiquette ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Screening Programs ◽  
Prevention And Early Detection ◽  
Screening And Prevention ◽  
Personalized Risk Assessment ◽  
Personalized Risk

Early detection of breast cancer through screening reduces breast cancer mortality. The benefits of screening must also be considered within the context of potential harms (e.g., false positives, overdiagnosis). Furthermore, while breast cancer risk is highly variable within the population, most screening programs use age to determine eligibility. A risk-based approach is expected to improve the benefit-harm ratio of breast cancer screening programs. The PERSPECTIVE I&I (Personalized Risk Assessment for Prevention and Early Detection of Breast Cancer: Integration and Implementation) project seeks to improve personalized risk assessment to allow for a cost-effective, population-based approach to risk-based screening and determine best practices for implementation in Canada. This commentary describes the four inter-related activities that comprise the PERSPECTIVE I&I project. 1: Identification and validation of novel moderate to high-risk susceptibility genes. 2: Improvement, validation, and adaptation of a risk prediction web-tool for the Canadian context. 3: Development and piloting of a socio-ethical framework to support implementation of risk-based breast cancer screening. 4: Economic analysis to optimize the implementation of risk-based screening. Risk-based screening and prevention is expected to benefit all women, empowering them to work with their healthcare provider to make informed decisions about screening and prevention.

scholarly journals A limited review of over diagnosis methods and long-term effects in breast cancer screening

2011 ◽  
pp. 143-147
Author(s):  
Dongfeng Wu ◽  
Adriana Pérez
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Screening Program ◽  
Critical Issue ◽  
Long Term Effects ◽  
Screening Programs ◽  
Probability Modeling

Breast cancer screening programs have been effective in detecting tumors prior to symptoms. Recently, there has been concern over the issue of over-diagnosis, that is, diagnosis of a breast cancer that does not manifest prior to death. Estimates for over-diagnosis vary, ranging from 7 to 52%. This variability may be due partially to issues associated with bias and/or incorrect inferences associated with the lack of probability modeling. A critical issue is how to evaluate the long-term effects due to continued screening. Participants in a periodic screening program can be classified into four mutually exclusive groups depending on whether individuals are diagnosed and whether their symptoms appear prior to death: True-earlydetection; No-early-detection; Over-diagnosis; and Not-sonecessary. All initially superficially healthy people will eventually fall into one of these four categories. This manuscript reviews the major methodologies associated with the over-diagnosis and long-term effects of breast cancer screening.

scholarly journals Recommendations on breast cancer screening and prevention in the context of implementing risk stratification: impending changes to current policies

2016 ◽  
Vol 23 (6) ◽  
pp. 615 ◽  
Author(s):  
J. Gagnon ◽  
E. Lévesque ◽  
F. Borduas ◽  
J. Chiquette ◽  
C. Diorio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Risk Stratification ◽  
Breast Cancer Screening ◽  
International Perspective ◽  
Individual Risk ◽  
Screening Programs ◽  
Cancer Screening And Prevention ◽  
Screening And Prevention ◽  
Tool Building

In recent years, risk stratification has sparked interest as an innovative approach to disease screening and prevention. The approach effectively personalizes individual risk, opening the way to screening and prevention interventions that are adapted to subpopulations. The international perspective project, which is developing risk stratification for breast cancer, aims to support the integration of its screening approach into clinical practice through comprehensive tool-building. Policies and guidelines for risk stratification—unlike those for population screening programs, which are currently well regulated—are still under development. Indeed, the development of guidelines for risk stratification reflects the translational aspects of perspective.Here, we describe the risk stratification process that was devised in the context of perspective, and we then explain the consensus-based method used to develop recommendations for breast cancer screening and prevention in a risk-stratification approach. Lastly, we discuss how the recommendations might affect current screening policies.

scholarly journals A limited review of over diagnosis methods and long-term effects in breast cancer screening

2011 ◽  
Vol 5 (3) ◽  
pp. 143 ◽  
Author(s):  
Dongfeng Wu ◽  
Adriana Pérez
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Screening Program ◽  
Critical Issue ◽  
Long Term Effects ◽  
Screening Programs ◽  
Probability Modeling

Breast cancer screening programs have been effective in detecting tumors prior to symptoms. Recently, there has been concern over the issue of over-diagnosis, that is, diagnosis of a breast cancer that does not manifest prior to death. Estimates for over-diagnosis vary, ranging from 7 to 52%. This variability may be due partially to issues associated with bias and/or incorrect inferences associated with the lack of probability modeling. A critical issue is how to evaluate the long-term effects due to continued screening. Participants in a periodic screening program can be classified into four mutually exclusive groups depending on whether individuals are diagnosed and whether their symptoms appear prior to death: True-earlydetection; No-early-detection; Over-diagnosis; and Not-sonecessary. All initially superficially healthy people will eventually fall into one of these four categories. This manuscript reviews the major methodologies associated with the over-diagnosis and long-term effects of breast cancer screening.

scholarly journals Breast Cancer Screening Among Medical Staff in Tehran, Iran: Improvement of Early Detection

2020 ◽  
Author(s):  
Hossein Yahyazadeh ◽  
Marzieh Beheshti ◽  
Azita Abdollahinejad ◽  
Maria Hashemian ◽  
Narges Sistany Allahabad ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Medical Staff ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Breast Diseases ◽  
Cross Sectional ◽  
Screening Programs

Breast cancer is the most prevalent Iranian female malignancy. Breast screening reduces the number of malignant breast diseases. We aimed to assess the results of the pilot breast cancer screening on early detection in female medical staff in Milad Hospital, Tehran, Iran. A cross-sectional study. Female medical staff from Milad Hospital, Tehran, Iran, were examined by a specialist in 2016. A checklist, including demographic data, was completed by the participants. If necessary, they referred to as sonography or mammography. Data were analyzed using SPSS software. Of 746 people enrolled, 137 had no pathological point, 609 had suspicious or positive findings that were referred for further investigation, 449 had normal findings, and 7 had suspicious mass and were biopsied, 6 were benign. One case had primary invasive cancer. Since screening for breast cancer helps to early detection of this disease, the implementation of cancer screening programs should be on the priority of health authorities.

scholarly journals Women's perceptions of personalized risk‐based breast cancer screening and prevention: An international focus group study

2019 ◽  
Vol 28 (5) ◽  
pp. 1056-1062 ◽  
Author(s):  
Linda Rainey ◽  
Anna Jervaeus ◽  
Louise S. Donnelly ◽  
D. Gareth Evans ◽  
Mattias Hammarström ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Focus Group ◽  
Breast Cancer Screening ◽  
Focus Group Study ◽  
Women’S Perceptions ◽  
Cancer Screening And Prevention ◽  
Screening And Prevention ◽  
Personalized Risk

Screening Sensitivity and Sojourn Time From Breast Cancer Early Detection Clinical Trials: Mammograms and Physical Examinations

2001 ◽  
Vol 19 (15) ◽  
pp. 3490-3499 ◽  
Author(s):  
Yu Shen ◽  
Marvin Zelen
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Cancer Screening ◽  
Early Detection ◽  
Physical Examination ◽  
Breast Cancer Screening ◽  
Sojourn Time ◽  
Screening Programs ◽  
Screening Sensitivity ◽  
Screening Trials

PURPOSE: To estimate sensitivities of breast cancer screening modalities and preclinical duration of the disease from eight breast cancer screening clinical trials. PATIENTS AND METHODS: Screening programs invariably lead to diagnosis of disease before signs or symptoms are present. Two key quantities of screening programs are the sensitivity of the disease detection modality and the mean sojourn time (MST). The observed screening histories in a periodically screened cohort make it possible to estimate these quantities of interest. We applied recently developed statistical methods to data from eight randomized breast cancer screening trials to estimate the sensitivities of early detection modalities and MST. Moreover, when a screening trial involved two screening modalities, our methods enabled the estimation of the individual sensitivity of each screening modality. RESULTS: We analyzed breast cancer data from several screening trials and have relatively complete data from the Health Insurance Plan (HIP), Edinburgh, and two Canadian studies. The screening sensitivity for mammography, physical examination, and MST were, respectively, HIP: 0.39, 0.47, and 2.5 years; Edinburgh: 0.63, 0.40, and 4.3 years; Canadian (age 40 to 49 at entry): 0.61, 0.59, and 1.9 years; Canadian (age 50 to 59 at entry): 0.66, 0.39, and 3.1 years. CONCLUSION: The public debate on early breast cancer detection is mainly centered on mammograms. However, the current study indicates that a physical examination is of comparable importance. Cautious interpretation of trial differences is required as a result of various experimental designs and the age dependency of screening sensitivity and MST.

scholarly journals Attributes, Performance, and Gaps in Current & Emerging Breast Cancer Screening Technologies

2019 ◽  
Vol 15 (2) ◽  
pp. 122-131
Author(s):  
Hina M. Ismail ◽  
Christopher G. Pretty ◽  
Matthew K. Signal ◽  
Marcus Haggers ◽  
J. Geoffrey Chase
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Screening Tests ◽  
Screening Methods ◽  
Extensive Literature ◽  
Screening Programs ◽  
Detection Techniques ◽  
Wide Range

Background:Early detection of breast cancer, combined with effective treatment, can reduce mortality. Millions of women are diagnosed with breast cancer and many die every year globally. Numerous early detection screening tests have been employed. A wide range of current breast cancer screening methods are reviewed based on a series of searchers focused on clinical testing and performance. </P><P> Discussion: The key factors evaluated centre around the trade-offs between accuracy (sensitivity and specificity), operator dependence of results, invasiveness, comfort, time required, and cost. All of these factors affect the quality of the screen, access/eligibility, and/or compliance to screening programs by eligible women. This survey article provides an overview of the working principles, benefits, limitations, performance, and cost of current breast cancer detection techniques. It is based on an extensive literature review focusing on published works reporting the main performance, cost, and comfort/compliance metrics considered.Conclusion:Due to limitations and drawbacks of existing breast cancer screening methods there is a need for better screening methods. Emerging, non-invasive methods offer promise to mitigate the issues particularly around comfort/pain and radiation dose, which would improve compliance and enable all ages to be screened regularly. However, these methods must still undergo significant validation testing to prove they can provide realistic screening alternatives to the current accepted standards.

scholarly journals Psychological predictors of intention and avoidance of attending organized mammography screening in Norway: applying the Extended Parallel Process Model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Ivanova ◽  
Ingela Lundin Kvalem
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Mammography Screening ◽  
Psychological Factors ◽  
Process Model ◽  
Parallel Process ◽  
Extended Parallel Process Model ◽  
Screening Programs ◽  
Response Efficacy

Abstract Background Mammography screening is the main method for early detection of breast cancer in Norway. Few studies have focused on psychological determinants of both attendance and non-attendance of publicly available mammography screening programs. The aim of the current study, guided by the Extended Parallel Process Model, was to examine how psychological factors influence defensive avoidance of breast cancer screening and intention to attend mammography. Methods Cross-sectional survey data from a community sample of women living in Norway aged ≥ 18 (N = 270), and without a history of breast cancer, was collected from September 2018 to June 2019 and used to investigate the relationships between the Extended Parallel Process Model (EPPM) constructs and two outcomes: defensive avoidance of breast cancer screening and intention to attend mammography within the next two years. After adjusting for confounding factors, the hierarchical multiple linear regression analyses was conducted to assess the ability of the independent variables based on the EPPM to predict the two outcome variables. Significance level was chosen at p < 0.05. Results Multivariate analyses showed that defensive avoidance of breast cancer screening was predicted by lower perceived susceptibility to breast cancer (β =  − 0.22, p = 0.001), lower response efficacy of mammography screening (β =  − 0.33, p = 0.001), higher breast cancer fear (β = 0.15, p = 0.014), and checking breasts for lumps (β =  − 0.23, p = 0.001). Intention to attend mammography within the next two years was predicted by higher response efficacy of mammography screening (β = 0.13, p = 0.032), having a lower educational level (β =  − 0.10, p = 0.041), and regular previous mammography attendance compared to never attending (β = 0.49, p = 0.001). Conclusions The study revealed that defensive avoidance of breast cancer screening and intention to attend mammography were not predicted by the same pattern of psychological factors. Our findings suggest future health promotion campaigns need to focus not only on the psychological factors that encourage women’s decision to attend the screening, but also to counter factors that contribute to women’s decision to avoid it.

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