Department of General Surgery, Ng Teng Fong General Hospital, Singapore, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
PLoS One. 2022 Mar 31;17(3):e0265965. doi: 10.1371/journal.pone.0265965. eCollection 2022.
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. 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. 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.
常规乳房 X 线筛查目前是发现早期癌症的标准工具，此时治疗最为成功。目前的乳房筛查计划是一刀切的，鼓励所有超过一定年龄阈值的女性参与。然而，乳腺癌风险因人而异。BREAst screening Tailored for HEr（BREATHE）研究旨在评估在新加坡进行基于综合风险的个性化乳房筛查的可接受性。超越当前基于年龄的筛查模式，BREATHE 整合了遗传和非遗传乳腺癌风险预测工具，以个性化筛查建议。 BREATHE 是一项针对约 3500 名女性的队列研究。第一次招募访问将包括问卷调查和颊拭子。在收到个性化的乳腺癌风险报告后，参与者将参加面对面的风险审查，然后进行最后一次评估，以确定我们的风险分层计划的可接受性。风险预测基于：a） Gail 模型（非遗传），b）乳房 X 线密度和召回，c）BOADICEA 预测（乳腺癌易感性基因），和 d）乳腺癌多基因风险评分。为了在全国范围内实施基于个人风险的乳房筛查，除了验证预测工具外，还必须探索目标人群中的可接受性。据我们所知，这是亚洲首次实施基于综合风险的乳房 X 线筛查计划的研究。 BREATHE 研究将为政策实施提供必要的数据，这将使医疗体系转变为提供更好的健康和医疗保健结果。
