Is Breastscreen up for change?

Risk-Based vs Annual Breast Cancer Screening: The WISDOM Randomized Clinical Trial

https://tinyurl.com/mpe28amd

Screening women for breast cancer has been a great success. The death rate for women aged 40-70 from breast cancer has been reduced by 45% following the introduction of mammographic screening every two years.

However, this has not been without criticism. The high cost and use of otherwise necessary resources, together with the great number of biopsies and psychological trauma due to cancer anxiety are stated as flaws in the scheme.

The WISDOM clinical trial compared personalized care to standard annual screening. In the randomized trial of over 28,000 women, half were assigned to a risk-based arm. In this arm, women were screened based on genetic and individual risk; for example, those at low risk were not assigned to start regular mammography until age 50. This group’s outcomes were compared to a similar-sized cohort assigned to annual screening.

The initial report shows no disadvantage in terms of advanced (stage IIIB) tumours. The number of biopsies was surprisingly similar in both groups. The authors suggest that risk-based screening is a viable alternative to the current regime.