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Overview of high-risk patient screening.

Overview of high-risk patient screening.

  • Abstract
  • Transcript

Dr. Dana HADDAD, MD, PHD, Radiology and women imaging department, Healthbay Polyclinic, Dubai, UAE

Breast cancer is the leading cause of malignancy in women globally and is the number one cause of cancer related-mortality, despite advances in screening tools and treatment. Therefore, more personalized population screening and preventative measures for early detection, including risk-based screening, which could reduce morbidity and mortality, are needed. Imaging, in addition to clinical breast exams, is an integral part of breast cancer screening and detection. Standard guidelines recommend standard 2D/3D mammography for all women, with adjunct breast ultrasound for women with dense breasts. However, there is increasing data to suggest that Magnetic Resonance Imaging (MRI) could be a valuable adjunct for the screening of women at increased risk for developing breast cancer, including those with dense breasts. MRI is considered the most sensitive imaging modality for detecting breast cancer, but has low specificity, requires intravenous gadolinium injection, and is associated with a higher false-positive rate and higher costs. The strongest risk factors for female breast cancer include age and genetic mutations. Additional known risk factors include breast density, family history, and reproductive history. Simulation modeling studies have provided insight regarding risk-based screening protocols, and suggest that screening regimens should be personalized based on a woman’s age, family history, breast density, and other risk factors. However, no formal randomized controlled trials have been conducted to evaluate the efficacy of risk-based screening. This talk will present an overview of risk assessment, breast cancer risk factors, how to measure and identify patient lifetime risk for developing breast cancer, and how to manage these patients with supplemental imaging tools such as breast ultrasound and contrast-enhanced MRI. It will also discuss cost-effectiveness and alternative approaches to high risk screening.

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  • October 20, 2023

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