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Perspective

Personalized Risk Assessment for Prevention and Early Detection of Breast Cancer: Integration and Implementation (PERSPECTIVE I&I)

by
Jennifer D. Brooks
1,
Hermann H. Nabi
2,3,4,
Irene L. Andrulis
5,
Antonis C. Antoniou
6,
Jocelyne Chiquette
2,7,
Philippe Després
8,
Peter Devilee
9,
Michel Dorval
2,4,10,11,
Arnaud Droit
12,
Douglas F. Easton
6,
Andrea Eisen
13,
Laurence Eloy
14,
Samantha Fienberg
15,
David Goldgar
16,
Eric Hahnen
17,
Yann Joly
18,
Bartha Maria Knoppers
18,
Aisha Lofters
19,
Jean-Yves Masson
2,4,
Nicole Mittmann
13,20,
Jean-Sébastien Paquette
7,
Nora Pashayan
21,
Rita Schmutzler
17,
Tracy Stockley
22,23,
Sean V. Tavtigian
16,
Meghan J. Walker
1,15,
Michael Wolfson
24,
Anna Maria Chiarelli
1,15,*,† and
Jacques Simard
2,12,*,†add Show full author list remove Hide full author list
1
Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada
2
CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada
3
Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec City, QC G1V 0A6, Canada
4
Université Laval Cancer Research Center, Québec City, QC G1R 3S3, Canada
5
Department of Molecular Genetics, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, University of Toronto, Toronto, ON M5G 1X5, Canada
6
Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge CB1 8RN, UK
7
Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, QC G1V 4G2, Canada
8
Department of Physics, Engineering Physics and Optics, Faculty of Science and Engineering, Université Laval, Québec City, QC G1V 0A6, Canada
9
Department of Human Genetics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
10
Faculty of Pharmacy, Université Laval, Québec City, QC G1V 4G2, Canada
11
CISSS de Chaudière-Appalaches Research Center, Lévis, QC G6V 3Z1, Canada
12
Department of Molecular Medicine, Faculty of Medicine, Université Laval, Québec City, QC G1V 4G2, Canada
13
Sunnybrook Health Science Center, Toronto, ON M4N 3M5, Canada
14
Programme Québécois de Cancérologie, Ministère de la Santé et des Services Sociaux, Québec City, QC G1S 2M1, Canada
15
Ontario Health, Cancer Care Ontario, Toronto, ON M5G 2L3, Canada
16
Department of Oncological Sciences and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
17
Centre for Familial Breast and Ovarian Cancer, Center for Integrated Oncology, Medical Faculty, University Hospital Cologne, 50937 Köln, Germany
18
Centre of Genomics and Policy, McGill University, Montreal, QC H3A 0G1, Canada
19
Women’s College Research Institute, Toronto, ON M5G 1N8, Canada
20
Canadian Agency for Drugs and Technologies in Health, Toronto, ON M5H 3Y9, Canada
21
Department of Applied Health Research, Institute of Epidemiology and Healthcare, University College London, London WC1E 6BT, UK
22
Division of Clinical Laboratory Genetics, University Health Network, Toronto, ON M5G 2C4, Canada
23
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
24
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
 
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*
Authors to whom correspondence should be addressed.
†
Senior authors.
Academic Editor: Gianluca Franceschini
J. Pers. Med. 2021, 11(6), 511; https://doi.org/10.3390/jpm11060511
Received: 4 May 2021 / Revised: 28 May 2021 / Accepted: 31 May 2021 / Published: 4 June 2021
(This article belongs to the Special Issue Personalized Approaches for the Prevention and Treatment of Breast Cancer)
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Abstract

Early detection of breast cancer through screening reduces breast cancer mortality. The benefits of screening must also be considered within the context of potential harms (e.g., false positives, overdiagnosis). Furthermore, while breast cancer risk is highly variable within the population, most screening programs use age to determine eligibility. A risk-based approach is expected to improve the benefit-harm ratio of breast cancer screening programs. The PERSPECTIVE I&I (Personalized Risk Assessment for Prevention and Early Detection of Breast Cancer: Integration and Implementation) project seeks to improve personalized risk assessment to allow for a cost-effective, population-based approach to risk-based screening and determine best practices for implementation in Canada. This commentary describes the four inter-related activities that comprise the PERSPECTIVE I&I project. 1: Identification and validation of novel moderate to high-risk susceptibility genes. 2: Improvement, validation, and adaptation of a risk prediction web-tool for the Canadian context. 3: Development and piloting of a socio-ethical framework to support implementation of risk-based breast cancer screening. 4: Economic analysis to optimize the implementation of risk-based screening. Risk-based screening and prevention is expected to benefit all women, empowering them to work with their healthcare provider to make informed decisions about screening and prevention. View Full-Text
Keywords: breast cancer; screening; risk prediction; risk stratification breast cancer; screening; risk prediction; risk stratification
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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MDPI and ACS Style

Brooks, J.D.; Nabi, H.H.; Andrulis, I.L.; Antoniou, A.C.; Chiquette, J.; Després, P.; Devilee, P.; Dorval, M.; Droit, A.; Easton, D.F.; Eisen, A.; Eloy, L.; Fienberg, S.; Goldgar, D.; Hahnen, E.; Joly, Y.; Knoppers, B.M.; Lofters, A.; Masson, J.-Y.; Mittmann, N.; Paquette, J.-S.; Pashayan, N.; Schmutzler, R.; Stockley, T.; Tavtigian, S.V.; Walker, M.J.; Wolfson, M.; Chiarelli, A.M.; Simard, J. Personalized Risk Assessment for Prevention and Early Detection of Breast Cancer: Integration and Implementation (PERSPECTIVE I&I). J. Pers. Med. 2021, 11, 511. https://doi.org/10.3390/jpm11060511

AMA Style

Brooks JD, Nabi HH, Andrulis IL, Antoniou AC, Chiquette J, Després P, Devilee P, Dorval M, Droit A, Easton DF, Eisen A, Eloy L, Fienberg S, Goldgar D, Hahnen E, Joly Y, Knoppers BM, Lofters A, Masson J-Y, Mittmann N, Paquette J-S, Pashayan N, Schmutzler R, Stockley T, Tavtigian SV, Walker MJ, Wolfson M, Chiarelli AM, Simard J. Personalized Risk Assessment for Prevention and Early Detection of Breast Cancer: Integration and Implementation (PERSPECTIVE I&I). Journal of Personalized Medicine. 2021; 11(6):511. https://doi.org/10.3390/jpm11060511

Chicago/Turabian Style

Brooks, Jennifer D., Hermann H. Nabi, Irene L. Andrulis, Antonis C. Antoniou, Jocelyne Chiquette, Philippe Després, Peter Devilee, Michel Dorval, Arnaud Droit, Douglas F. Easton, Andrea Eisen, Laurence Eloy, Samantha Fienberg, David Goldgar, Eric Hahnen, Yann Joly, Bartha Maria Knoppers, Aisha Lofters, Jean-Yves Masson, Nicole Mittmann, Jean-Sébastien Paquette, Nora Pashayan, Rita Schmutzler, Tracy Stockley, Sean V. Tavtigian, Meghan J. Walker, Michael Wolfson, Anna Maria Chiarelli, and Jacques Simard. 2021. "Personalized Risk Assessment for Prevention and Early Detection of Breast Cancer: Integration and Implementation (PERSPECTIVE I&I)" Journal of Personalized Medicine 11, no. 6: 511. https://doi.org/10.3390/jpm11060511

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