Evaluation of high-risk screening for breast cancer in the south Swedish health care region
Women with a high risk for breast cancer are defined as having (i) a life-time risk of a new primary breast cancer >20%, based on the prevalence of hereditary gene mutation (BRCA1, BRCA2 etc.), (ii) a positive family history, or (iii) previously diagnosed breast cancer before 50 years of age. High-risk patients have a higher incidence of breast cancer, with lesions appearing earlier age and growing faster than in the average woman, however, younger women tend to have denser breasts, which affects the detectability of cancer by mammography. Therefore, adjunctive screening methods are needed to increase the cancer detection. Magnetic resonance imaging (MRI) is one of a clinical imaging modality that can address challenges of screening women with high-risk of breast cancer. Breast MRI has been shown to be more sensitive for detecting early and small breast cancers than digital mammography or ultrasound. Therefore, according to Swedish guidelines, annual screening with breast MRI for high-risk women is recommended.
Our research propose is to investigate the outcome of the high-risk screening program in relation to diagnostic imaging, including breast MRI in the south Swedish healthcare region since the start in 1995. The results will be used to assess the utility of MRI in high-risk screening, and to understand potential differences in the cohort.
Implications for practice in healthcare and research: The proposed project is aimed at evaluating imaging data of the high-risk breast cancer screening related to clinical information. This study will add to the bigger picture in understanding the impact of high-risk breast cancer screening over a timeframe of more than 20 years. The information obtained from this project would help us identify the strengths and limitations of the current utility of high-risk screening using MRI and suggest appropriate modifications as individualized risk-based high-risk screening programs in the future.
Co-workers in the project: Our group is a multidisciplinary team, consisting of the radiologist, Akane Ohashi, (MD, PhD, post-doctoral researcher); Sophia Zackrisson (MD, PhD, Professor); medical oncologist, Niklas Loman, (MD, PhD, Associate Professor); radiology nurse, Anetta Bolejko, (PhD, Associate professor, Radiographer); medical physicist, Daniel Förnvik, (PhD, Associate Professor); and Karin Henriksson (data manager at the Department of Clinical genetics), all at Skåne University Hospital.
Funding: Japanese Scandinavian Radiological Society, Japanese Society for Magnetic Resonance in Medicine, and Governmental Funding of Clinical Research within the National Health Services
Akane [dot] Ohashi [at] med [dot] lu [dot] se