Breast cancer develops in 1 out of 8 women in EU28 before the age of 85, and 20% of cases occur in women younger than 50. It remains the most lethal malignancy in women across the world.
Current breast cancer screening programmes are based primarily on age. The guidelines do not support regular screening of women younger than 50 and thus largely exclude potentially high-risk women in younger age groups from screening. It is no longer appropriate to apply a single recommendation to women across all age groups and risk profiles. A far more precise approach is needed.
The screening decision should depend on a woman’s risk for breast cancer and her values and preferences. Simulation models suggest that tailoring screening frequency based on individual risk factor profiles may be more cost-effective than uniform screening. The use of genetic risk thresholds rather than age may also identify candidates for screening more efficiently. For breast cancer, 31% of variability may be associated with genetic factors and 16% with shared environmental factors.
We are currently developing a comprehensive screening model for breast cancer that creates practical solutions for the dynamic design of screening intervals based on a patient’s assignment to an individual risk category.