While most women already undergo mammograms to help detect breast cancer, there has been significant controversy about how frequently women need to be screened. To help answer that question, researchers are developing a customized risk model to recommend how often a woman should have a mammogram based on her unique risk factors.

“This could change how we provide breast care,” said Jennifer Harvey, MD, professor of radiology at the University of Virginia (UVA) School of Medicine (Charlottesville, USA). “Women will have personalized knowledge to make decisions about getting screened.”

Dr. Harvey and William Knaus, MD, professor of public health sciences, were part of a research team that recently received a USD 5.5 million grant from the US Department of Defense Congressionally Directed Medical Research Programs to fund the initial phase of a study to develop the risk model.

While recommendations for breast cancer screenings are now “one-size-fits-all” largely based on a woman’s age, Dr. Harvey noted, the new risk model could generate very different recommendations for women of the same age. Lower-risk women may be advised to undergo a breast cancer screening every other year, whereas women at higher risk may be recommended to have more frequent screenings with more sensitive equipment such as magnetic resonance imaging (MRI).

The risk model will combine medical data with guidance from women on how they would like to approach screenings for breast cancer. Existing risk models are largely based on a woman’s personal or family history of cancer; UVA’s risk model will add breast density, which is one of the strongest indicators of a woman’s breast cancer risk.

As part of the study, Drs. Harvey and Knaus will work with Martin Yaffe, MSc, PhD, a senior scientist at Sunnybrook Health Sciences Center (Toronto, Canada) to determine which of two methods is best for rapidly measuring breast density using digital mammograms.

To complete the risk model, a series of phone surveys and focus groups will collect data from women about their perspectives on screening for breast cancer. “Some women have concerns about the radiation exposure from mammograms, while other women may want to take a more aggressive approach to screening,” Dr. Knaus stated.

Drs. Harvey and Knaus plan to spend the next three years developing and corroborating the screening model at UVA before testing it through a US study; if successful, the model could be available for widespread use in five to six years.

 

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