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Screening strategy modification based on personalized breast cancer risk stratification and its implementation in the national guidelines – pilot study Cover

Screening strategy modification based on personalized breast cancer risk stratification and its implementation in the national guidelines – pilot study

Open Access
|Oct 2020

Figures & Tables

Breast cancer risk categories for Slovenian women_

Breast cancer risk category
Low risk (%)Population risk (%)Moderately increased risk (%)High risk (%)
Lifetime risk between ages 20 and 39-<1616 and higher>30
10-year risk between ages 40 and 49-<2.02.0 to 6.5>6.5
10-year risk between ages 50 and 59<1.31.3 to<4.04.0 to 6.5>6.5
10-year risk from age 60+<1.31.3 to<5.55.5 to 6.5>6.5

Characteristics of the studied women according to breast cancer risk factors_

Number of womenPercent (%)
Age groups
20-39 years8744.2
40-49 years10452.8
50-59 years63.0
Family history
positive6231.5
negative13568.5
Age at menarche
<11 years73.6
11-12 years5728.9
13-14 years10854.8
>15 years2512.7
Age at first full-term birth
<25 years8141.1
25-29 years5427.4
>30 years3115.7
nulliparous3115.7

The summary of criteria for the higher risk women category and advised breast cancer screening tests according to current Rules on Carrying Out Preventive Health Care at the Primary Level (5)_

Criteria for higher breast cancer risk category (at least one of the following)Screening tests at a Breast Unit for the higher breast cancer risk category (after the age of 40)
First full-term birth >30 years
Clinical breast examination (every 12-24 months) and Mammography and/or ultrasound examination of the breast or No screening is performed according to clinician decision
At least one relative (mother, sister, daughter) with breast cancer
Personal history of breast disease that increases breast cancer risk
Personal history of breast cancer in the past

Comparison of anticipated mammographic screening and screening foreseen in the new Slovenian guidelines by breast cancer risk categories and age groups_

Anticipated mammographic screening (number of women)
Mammographic screening according to the new Slovenian guidelines (number of women)
Breast cancer risk category

Risk category was determined by S-IBIS calculation, and division into risk groups was performed as proposed in Table 3.

Population riskModerately increased riskPopulation riskModerately increased risk
Ages between 20 and 395400
Ages between 40 and 494327034
Ages between 50 and 551-6-
All ages4931634

Comparison of anticipated ultrasound screening for breast cancer prevention and screening foreseen in the new Slovenian guidelines by breast cancer risk categories and age groups_

Anticipated ultrasound screening (number of women)
Ultrasound screening according to the new Slovenian guidelines
Breast cancer risk category

Risk category was determined by S-IBIS calculation, and division into risk groups was performed as proposed in Table 3.

Population riskModerately increased riskPopulation riskModerately increased risk
Ages between 20 and 3973According to the new guidelines ultrasound screening is recommended only upon referral from a radiologist
Ages between 40 and 49149
Ages between 50 and 550-
All ages2112
DOI: https://doi.org/10.2478/sjph-2020-0027 | Journal eISSN: 1854-2476 | Journal ISSN: 0351-0026
Language: English
Page range: 211 - 218
Submitted on: Mar 24, 2020
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Accepted on: Aug 31, 2020
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Published on: Oct 18, 2020
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2020 Mateja Krajc, D Gareth Evans, Ana Blatnik, Katarina Lokar, Tina Žagar, Sonja Tomšič, Janez Žgajnar, Vesna Zadnik, published by National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.