Determination of thresholds of risk in women at average risk of breast cancer to personalize the organized screening program

Abstract In France, more than 10 million women at ”average” risk of breast cancer (BC), are included in the organized BC screening. Existing predictive models of BC risk are not adapted to the French population. Thus, we set up a new score in the French Hérault region and looked for subgroups at a g...

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Autores principales:	Emmanuel Bonnet, Jean-Pierre Daures, Paul Landais
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a319d59aa02d4ebd82d8477a7f0ec142
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spelling	oai:doaj.org-article:a319d59aa02d4ebd82d8477a7f0ec1422021-12-02T17:37:34ZDetermination of thresholds of risk in women at average risk of breast cancer to personalize the organized screening program10.1038/s41598-021-98604-62045-2322https://doaj.org/article/a319d59aa02d4ebd82d8477a7f0ec1422021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98604-6https://doaj.org/toc/2045-2322Abstract In France, more than 10 million women at ”average” risk of breast cancer (BC), are included in the organized BC screening. Existing predictive models of BC risk are not adapted to the French population. Thus, we set up a new score in the French Hérault region and looked for subgroups at a graded level of risk in women at ”average” risk. We recruited a retrospective cohort of women, aged 50 to 60, who underwent the organized BC screening, and included 2241 non-cancer women and 527 who developed a BC during a 12-year follow-up period (2006-2018). The risk factors identified were high breast density (ACR BI-RADS grading)(B vs A: HR = 1.41, 95%CI [1.05; 1.9], p = 0.023; C vs A: HR = 1.65 [1.2; 2.27], p = 0.02 ; D vs A: HR = 2.11 [1.25;3.58], p = 0.006), a history of maternal breast cancer (HR = 1.61 [1.24; 2.09], p < 0.001), and socioeconomic difficulties (HR 1.23 [1.09; 1.55], p = 0.003). While early menopause (HR = 0.36 [0.13; 0.99], p = 0.003) and an age at menarche after 12 years (HR = 0.77 [0.63; 0.95], p = 0.047) were protective factors. We identified 3 groups at risk: lower, average, and higher, respectively. A low threshold was characterized at 1.9% of 12-year risk and a high threshold at 4.5% 12-year risk. Mean 12-year risks in the 3 groups of risk were 1.37%, 2.68%, and 5.84%, respectively. Thus, 12% of women presented a level of risk different from the average risk group, corresponding to 600,000 women involved in the French organized BC screening, enabling to propose a new strategy to personalize the national BC screening. On one hand, for women at lower risk, we proposed to reduce the frequency of mammograms and on the other hand, for women at higher risk, we suggested intensifying surveillance.Emmanuel BonnetJean-Pierre DauresPaul LandaisNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Emmanuel Bonnet Jean-Pierre Daures Paul Landais Determination of thresholds of risk in women at average risk of breast cancer to personalize the organized screening program
description	Abstract In France, more than 10 million women at ”average” risk of breast cancer (BC), are included in the organized BC screening. Existing predictive models of BC risk are not adapted to the French population. Thus, we set up a new score in the French Hérault region and looked for subgroups at a graded level of risk in women at ”average” risk. We recruited a retrospective cohort of women, aged 50 to 60, who underwent the organized BC screening, and included 2241 non-cancer women and 527 who developed a BC during a 12-year follow-up period (2006-2018). The risk factors identified were high breast density (ACR BI-RADS grading)(B vs A: HR = 1.41, 95%CI [1.05; 1.9], p = 0.023; C vs A: HR = 1.65 [1.2; 2.27], p = 0.02 ; D vs A: HR = 2.11 [1.25;3.58], p = 0.006), a history of maternal breast cancer (HR = 1.61 [1.24; 2.09], p < 0.001), and socioeconomic difficulties (HR 1.23 [1.09; 1.55], p = 0.003). While early menopause (HR = 0.36 [0.13; 0.99], p = 0.003) and an age at menarche after 12 years (HR = 0.77 [0.63; 0.95], p = 0.047) were protective factors. We identified 3 groups at risk: lower, average, and higher, respectively. A low threshold was characterized at 1.9% of 12-year risk and a high threshold at 4.5% 12-year risk. Mean 12-year risks in the 3 groups of risk were 1.37%, 2.68%, and 5.84%, respectively. Thus, 12% of women presented a level of risk different from the average risk group, corresponding to 600,000 women involved in the French organized BC screening, enabling to propose a new strategy to personalize the national BC screening. On one hand, for women at lower risk, we proposed to reduce the frequency of mammograms and on the other hand, for women at higher risk, we suggested intensifying surveillance.
format	article
author	Emmanuel Bonnet Jean-Pierre Daures Paul Landais
author_facet	Emmanuel Bonnet Jean-Pierre Daures Paul Landais
author_sort	Emmanuel Bonnet
title	Determination of thresholds of risk in women at average risk of breast cancer to personalize the organized screening program
title_short	Determination of thresholds of risk in women at average risk of breast cancer to personalize the organized screening program
title_full	Determination of thresholds of risk in women at average risk of breast cancer to personalize the organized screening program
title_fullStr	Determination of thresholds of risk in women at average risk of breast cancer to personalize the organized screening program
title_full_unstemmed	Determination of thresholds of risk in women at average risk of breast cancer to personalize the organized screening program
title_sort	determination of thresholds of risk in women at average risk of breast cancer to personalize the organized screening program
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/a319d59aa02d4ebd82d8477a7f0ec142
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Determination of thresholds of risk in women at average risk of breast cancer to personalize the organized screening program

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