Breast cancer is the most common cancer in Australian women, and the second leading cause of cancer death. The Pathways–Breast Cancer Group is working on three overlapping streams of work that aim to reduce the burden of breast cancer:
Policy, evaluation and implementation studies about existing health services for breast cancer
The team is leading a project funded by the Australian Department of Health, ‘Optimising Early Detection of Breast Cancer in Australia’ (OEDBCA). This project is exploring options for risk-based, personalised approaches to breast-cancer screening in Australia, through a range of activities including evidence summaries, analysis of population data, stakeholder consultation and modelled evaluations.
The team is jointly leading the BRAVO ‘Toward Tailored Screening Project’, in collaboration with BreastScreen Victoria and the Peter McCallum Cancer Centre. This project is part of the Victorian Comprehensive Cancer Centre’s Precision Prevention and Tailored Screening program, working to better understand the feasibility, costs and acceptability of routine risk assessment within the BreastScreen Victoria program.
Clinical and health economic modelling
We know two-yearly mammographic screening is the most effective screening test for breast cancer for women aged 50-74 years, and more personalised screening protocols might find cancers earlier. Using the predictive modelling platform Policy1–Breast, the team is performing modelled evaluations of the BreastScreen Australia program to assess the benefits, harms and costs of screening. This includes modelling the effects of COVID-related disruptions, and evaluating the potential of more risk-based screening to detect cancer earlier and improve breast cancer outcomes.
This work includes looking at options related to mammographic breast density. Women who have a lot of dense breast tissue have a higher risk of breast cancer. The team is exploring the value of screening protocols that incorporate a density measurement and offer medical imaging tests tailored to suit each woman’s breast – the ‘best test for the breast’.
Precision risk assessment
Using Artificial Intelligence and complex algorithms, the team is analysing large datasets to identify combinations of risk factors that can help estimate whether women have a higher or lower than average risk of breast cancer or screening outcomes such as interval cancers. This includes research and development work in collaboration with CSIRO on the AutoDensity tool for measuring breast density from screening mammograms.
“We’re building evidence on the benefits, potential harms and costs of different breast screening approaches to optimise early detection and ultimately save more lives.”