New trial to weigh breast cancer screening


The outcome could have a profound effect on how women like 63-year-old Maria Norman protect themselves from breast cancer.

"My mother died; she was diagnosed with cancer at 34, breast cancer, and she died at 37," says Maria, "And left behind four children."

To better understand her own risk, Norman joined a program run by the University of California called the Athena Breast Health Network. In exchange for providing detailed information on her health history and that of her family, she received a risk assessment for breast cancer. The organization constantly analyzes and refines statistical data gathered from tens of thousands of participants.

The Athena program was created nearly five years ago with the goal of creating a personalized strategy for treating breast cancer. But it could soon also help provide the framework for a ground breaking clinical trial examining the best ways to screen for the disease.

"I don't want to argue about it anymore," says UCSF breast cancer surgeon Laura Esserman, M.D.

Esserman has been at the center of a national controversy for suggesting that many women may not benefit from yearly mammograms, arguing instead for more risk-based screening. Now along with other organizers of Athena, she's proposing a clinical trial that would test the effectiveness of recently developed tools, including fast evaluation of genetic markers linked to different breast cancers.

"And they've identified 60 or 70 of these differences that actually probably make up a reasonable chunk of the increased risk for breast cancer," argues Esserman.

She says a trial would also take a focused look at risk factors such as breast density and the value of imaging methods beyond mammography. At least one health insurance provider has expressed support for a screening trial.

"I think it's really important that we move away from a one-size-fits-all model, because even the providers in the medical community can't agree on one that fits all," says Lauren Ryan, MS, CGC, a genetic counselor with the Athena program.

Esserman says the team will examine a variety of current screening regimens, as well as the genetics of patients and the different types of breast cancers that appear. The group plans to meet next month with Rep. Jackie Speier, D-San Mateo, and representatives from Blue Shield and the National Committee For Quality Assurance. The goal is to secure funding and resources to begin a screening trial as early as January.

"We owe this to women, to do a better job, to take our modern tools and help us learn how to screen in 2014," says Esserman.

Written and produced by Tim Didion

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