Personalized early detection and prevention of breast cancer: ENVISION consensus statement

Nora Pashayan, Antonis C Antoniou, Urska Ivanus, Laura J Esserman, Douglas F Easton, David French, Gaby Sroczynski, Per Hall, Jack Cuzick, D Gareth Evans, Jacques Simard, Montserrat Garcia-Closas, Rita Schmutzler, Odette Wegwarth, Paul Pharoah, Sowmiya Moorthie, Sandrine De Montgolfier, Camille Baron, Zdenko Herceg, Clare TurnbullCorinne Balleyguier, Paolo Giorgi Rossi, Jelle Wesseling, David Ritchie, Marc Tischkowitz, Mireille Broeders, Dan Reisel, Andres Metspalu, Thomas Callender, Harry de Koning, Peter Devilee, Suzette Delaloge, Marjanka K Schmidt, Martin Widschwendter

Research output: Contribution to journalReview articlepeer-review

Abstract

The European Collaborative on Personalized Early Detection and Prevention of Breast Cancer (ENVISION) brings together several international research consortia working on different aspects of the personalized early detection and prevention of breast cancer. In a consensus conference held in 2019, the members of this network identified research areas requiring development to enable evidence-based personalized interventions that might improve the benefits and reduce the harms of existing breast cancer screening and prevention programmes. The priority areas identified were: 1) breast cancer subtype-specific risk assessment tools applicable to women of all ancestries; 2) intermediate surrogate markers of response to preventive measures; 3) novel non-surgical preventive measures to reduce the incidence of breast cancer of poor prognosis; and 4) hybrid effectiveness-implementation research combined with modelling studies to evaluate the long-term population outcomes of risk-based early detection strategies. The implementation of such programmes would require health-care systems to be open to learning and adapting, the engagement of a diverse range of stakeholders and tailoring to societal norms and values, while also addressing the ethical and legal issues. In this Consensus Statement, we discuss the current state of breast cancer risk prediction, risk-stratified prevention and early detection strategies, and their implementation. Throughout, we highlight priorities for advancing each of these areas.

Original languageEnglish
Pages (from-to)687-705
Number of pages19
JournalNature Reviews Clinical Oncology
Volume17
Issue number11
DOIs
Publication statusPublished - Nov 2020

Keywords

  • Breast Neoplasms/diagnosis
  • Consensus
  • Early Detection of Cancer
  • Evidence-Based Medicine
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Mass Screening
  • Precision Medicine

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