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ROSA - A roadmap for individualised breast screening

A radiographer and client in front of a mammography machine.

Our knowledge of breast cancer risk factors and breast screening has advanced enormously over the past 20 years. Drawing on this knowledge, a research project is underway to look at how clients could benefit from individualised breast screening.

Funded by the Australian Government Department of Health and led by Cancer Council Australia, the Roadmap to Optimising Screening in Australia (ROSA) project is investigating how the BreastScreen program, and other health services, can be personalised for clients with different levels of breast cancer risk.

The BreastScreen program saves lives through the early detection of breast cancer. ROSA is looking at the complex factors that impact breast cancer risk and breast screening by using the best available evidence and evaluations based on Australian modelling, as well as working with health service, research and policy partners.

Age remains the biggest risk factor with most breast cancers occurring in women over the age of 50. Other factors including family history, lifestyle, a history of benign breast problems, genetic information and breast density can indicate breast cancer risk. Breast density can also reduce the accuracy of breast screening.

ROSA is also looking at contemporary technologies and innovations such as breast imaging methods, new approaches to risk assessment, and the use of Artificial Intelligence to combine current and past client clinical information to help categorise breast cancer risk.

ROSA aims to answer some important questions:

  • Which type of breast screening technology, and screening intervals, should be offered to women in different risk groups?
  • How and when should risk be assessed, and which health professionals should be involved?
  • Which age groups should have risk considered as part of breast screening?
  • How would risk-based screening relate to other services in primary care (for example, GPs and hospitals) and family cancer centres?

ROSA is led by Associate Professor Carolyn (Caz) Nickson supported by a team of researchers at the Daffodil Centre (a partnership between the University of Sydney and Cancer Council NSW) and a dedicated Expert Advisory Group including BreastScreen representatives.

“Thanks to an international community of researchers, new evidence is emerging all the time. This builds the case for breast cancer screening services to provide more personalised screening,” said A/Prof Nickson.

“Our goal is to reach consensus on the best approach to screening women in different risk groups, and to map out how screening and clinical health services could work together as smoothly as possible if more risk-based screening protocols are recommended.”

BreastScreen Victoria CEO Terri Smith is a member of the ROSA Expert Advisory Group. She said: “I am so pleased to part of the advisory committee for this important work. It is important that we focus on the future of breast screening and how we can continue to improve this crucial population-based screening program.”

BreastScreen Victoria will continue to share updates about the ROSA project. For more information, visit the Cancer Council Australia website.