Breast cancer screening for everywoman?

Breast cancer is the most common cancer in women. Many have a family history. Scientists investigated when early detection should start using more than five million patient records.

Breast cancer alone accounts for a quarter of all new cancer cases and leads to death in 15%. In recent decades, screening programs have been established to reduce mortality rates. This is because many treatment options are more effective in the early stages. To date, women aged 50-69 are generally invited to participate in mammography every two years. If genetic risk factors, such as BRCA1, BRCA2, or PALB2 mutations, are present, the guideline provides for an earlier start of screening for high-risk patients.

Until now, the data available for a differentiated estimation of breast cancer risk in women with a family history of breast cancer were thin. This is because the risk varies depending on the age of the affected person, the number of relatives affected, and the age at which the relative became ill. In a large study, more than five million data were therefore analyzed. During the study period, a total of 118,953 women were affected by breast cancer. 13.6 percent had relatives with breast cancer at the time of their own diagnosis. Based on familial risks associated with number and age at diagnosis of first- and second-degree relatives, researchers determined risk-adjusted starting ages for early breast cancer detection in women with varying degrees of family history.
Breast cancer risk varied greatly depending on the number of first- and second-degree relatives with the disease. And the age of onset of the disease in first-degree relatives also had an impact. For example, a woman whose sister developed breast cancer at age 43 reaches the average risk of 50-year-old women at age 38. In this case, early breast cancer detection should begin twelve years earlier. With an individual calculation of personal risk, in addition to taking into account other risk factors, breast cancer detection could be adjusted accordingly.

Source: “Familial risk of breast cancer: at what point does early breast cancer detection make sense?”, Nov. 15, 2019, National Center for Tumor Diseases (NCT) Heidelberg (D).