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BREAst screening Tailored for HEr (BREATHE) - A Study Protocol On Personalised Risk-based Breast Cancer Screening Programme

By Jenny Liu, Peh Joo Ho, Tricia Hui Ling Tan, Yen Shing Yeoh, Ying Jia Chew, Nur Khaliesah Mohamed Riza, Alexis Jiaying Khng, Su-Ann Goh, Yi Wang, Han Boon Oh, Chi Hui Chin, Sing Cheer Kwek, Zhi Peng Zhang, Desmond Luan Seng Ong, Swee Tian Quek, Chuan Chien Tan, Hwee Lin Wee, Jingmei Li, Philip Tsau Choong Iau, Mikael Hartman

Posted 18 Oct 2021
medRxiv DOI: 10.1101/2021.10.12.21264928

Background: Routine mammography screening is currently the standard tool for finding cancers at an early stage, when treatment is most successful. Current breast screening programmes are one-size-fits-all which all women above a certain age threshold are encouraged to participate. However, breast cancer risk varies by individual. The BREAst screening Tailored for HEr (BREATHE) study aims to assess acceptability of a comprehensive risk-based personalised breast screening in Singapore. Methods/Design: Advancing beyond the current age-based screening paradigm, BREATHE integrates both genetic and non-genetic breast cancer risk prediction tools to personalise screening recommendations. BREATHE is a cohort study targeting to recruit ~3,500 women. The first recruitment visit will include questionnaires and a buccal cheek swab. After receiving a tailored breast cancer risk report, participants will attend an in-person risk review, followed by a final session assessing the acceptability of our risk stratification programme. Risk prediction is based on: a) Gail model (non-genetic), b) mammographic density and recall, c) BOADICEA predictions (breast cancer predisposition genes), and d) breast cancer polygenic risk score. Discussion: For national implementation of personalised risk-based breast screening, exploration of the acceptability within the target populace is critical, in addition to validated predication tools. To our knowledge, this is the first study to implement a comprehensive risk-based mammography screening programme in Asia. The BREATHE study will provide essential data for policy implementation which will transform the health system to deliver a better health and healthcare outcomes.

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