Risk-Stratified Breast Cancer Screening

Abstract

 Current breast cancer screening programs have been established in many countries to reduce breast cancer mortality. The Japan breast cancer screening program has started since 2000 with mammography. However, there is no evidence to reduce breast cancer mortality in Japan even though 22 years have passed since then. Screening mammography might not be suitable for Japanese women because Japanese women with dense breasts are common that results in a lower sensitivity of mammography, due to the masking effect. We must shake things up and look for a new angle. For women with dense breasts, early detection of small invasive cancers needs go beyond mammography. So, risk-stratified breast cancer screening is particularly important for a next-generation breast cancer screening program in Japan. Therefore, we must make Japanese breast cancer risk assessment model and should introduce a risk-stratified breast cancer screening program based on an organized breast cancer screening program with breast cancer awareness campaign so that it may become an optimal program based on scientific evidence with decreasing breast cancer mortality and high participation rate. I'd like propose screening breast ultrasound as a supplemental modality for Japanese women with dense breasts based on the J-START results.