The p.I.n.k. study approach for supporting personalized risk assessment and early diagnosis of breast cancer

Michela Franchini, Stefania Pieroni, Edgardo Montrucchio, Jacopo Nori Cucchiari, Cosimo Di Maggio, Enrico Cassano, Brunella Di Nubila, Gian Marco Giuseppetti, Alberto Nicolucci, Gianfranco Scaperrotta, Paolo Belli, Sonia Santicchia, Sabrina Molinaro

Research output: Contribution to journalArticlepeer-review


Breast cancer is a clear example of excellent survival when it is detected and properly treated in the early stage. Currently, screening of this cancer relies on mammography, which may be integrated by new imaging techniques for more exhaustive evaluation. The Personalized, Integrated, Network, Knowledge (P.I.N.K.) study is a longitudinal multicentric study involving several diagnostic centres across Italy, co-ordinated by the Italian National Research Council and co-funded by the Umberto Veronesi Foundation. Aim of the study is to evaluate the increased diagnostic accuracy in detecting cancers obtained with different combinations of imaging technologies, and find the most effective diagnostic pathway matching the characteristics of an individual patient. The study foresees the enrolment of 50,000 women over the age of 40 years presenting for breast examination and providing informed consent to data handling. So far, the 15 participating centres across Italy have recruited a total of 22,848 patients. Based on the analyses of the first 175 histopathological-proven breast cancers, mammographic sensitivity was estimated to be 61.7% (n = 108 cancers), whereas diagnostic accuracy increased by 35.5% (n = 44 cancers) when mammography was integrated with other imaging modalities (ultrasound and/or digital breast tomosynthesis). Increase was mainly determined by ultrasound alone. Given the ongoing data collection and recruitment, the number of cancers detected is too low to allow any further in-depth analysis to explore links to patient characteristics. Past studies show that the uniform approach of population screening guidelines should be revised in favour of more personalised regimens, where known standards are integrated by imaging techniques most suitable for the individual’s characteristics. With the ultimate goal of identifying early breast cancer detection strategies, our preliminary results suggest that integrated diagnostic approach could lead to a paradigm shift from an age-based regimen toward more specific and effective risk-based personalised screening regimens, in order to reduce mortality from breast cancer.

Original languageEnglish
Article number2456
Pages (from-to)1-16
Number of pages16
JournalInternational Journal of Environmental Research and Public Health
Issue number5
Publication statusPublished - Mar 1 2021


  • Breast cancer
  • Early diagnosis
  • Integrated imaging techniques
  • Personalized medicine
  • Web based data collection

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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