Posted on Oct. 25, 2021, 6:08 p.m.Updated on Oct 25, 2021, 6:09 PM
Review the use of mammograms to better target breast cancer screening according to the risks of each. This is the objective of a vast study carried out in several countries, including France. At present, screening programs for the disease apply the same procedure to most of the women belonging to the age group concerned.
“We want to make reasonable use of mammograms: use them more if there is more need and less if there is less need”, summarized the radiologist Corinne Balleyguier, coordinator of the French part of the study. This, called MyPeBS for “My personal breast screening”, has been carried out since 2019 in six countries (Belgium, Spain, France, Israel, Italy, United Kingdom) and aims to assess the interest of ‘better differentiated screening according to the situation of each woman.
Several risk factors
Currently, screening programs apply the same procedure to most of the women in the relevant age group. In France, for example, all women aged 50 to 74 are encouraged to request a mammogram every two years. However, “we know that the risk is not the same according to the women”, recalls Corinne Balleyguier. In fact, there are already different protocols in France for women at risk of certain hereditary forms, but this remains in the minority.
The women studied by MyPeBS will be divided into two groups. One will follow the classic screening program in the country concerned. The other will follow a more individualized program. Women in the second group have their degree of risk assessed based on several factors: breast density (the denser breasts being more at risk), family history, past biopsies and, from saliva tests, the presence of non-hereditary genetic variations. .
They are then classified into four categories which undergo more or less close examinations. A mammogram every four years for those less at risk, a mammogram every two for medium risks, one mammogram per year for high risks, to which an MRI is added if the risk is considered particularly high.
65,000 patients to be recruited
If the study reveals that this differentiated strategy is more effective in detecting breast cancer, the implications for public health would be considerable. As it is currently practiced, massive screening is in fact the object of recurring criticism because it distinguishes too little between patients, at the risk in particular of provoking unnecessary treatments.
But the responses from MyPeBS will take a long time to come. For the time being, less than 20,000 patients have been recruited when they must be a total of 85,000. “It’s something quite heavy to manage in terms of organization; it’s much more complicated to include (patients) than it seems, ”lamented Corinne Balleyguier.
The Covid crisis has helped slow down these procedures and the first conclusions should not be given before 2026. By then, interested patients have until the summer of 2023 to propose themselves. Candidates, who must be between 40 and 70 years old, can visit the study site for more information.