October is the month dedicated internationally to the prevention of breast cancer, a disease that can be cured if one acts in time.
Prevenzione Serena is the regional cancer screening program: born with a mammogram screening, it has existed for 25 years and offers a free path to the early diagnosis of breast cancer to all women residing or domiciled in Piedmont, in the age group 45-74 years. It is active throughout the territory and is conducted by units coordinated with each other at the regional level. In 25 years, 3,870,355 invitations and 2,450,170 invitations were sent.
"We are proud of a system that is giving excellent results and is now consolidated: we need to increase awareness on the part of those who respond, also through targeted information initiatives on the importance of prevention in oncology", says Councilor for Health, Antonio Saitta.
The planned screening protocol (target age groups, interval between one test and the next, assessment tests) responds to the most authoritative scientifically founded guidelines. The process is part of the Essential Assistance Levels (Lea), is subject to strict quality controls and is implemented by trained, continuously updated and highly specialized operators. Each mammogram is read in duplicate, ie by two radiologists separately, to minimize the risk of error.
Prevenzione Serena identifies about 1500 cases each year, or just under 40% of all breast cancers diagnosed in Piedmont. Of these, almost a third are small tumors, less than 10 mm, and have a very favorable prognosis.
The effectiveness of mammographic screening in decreasing cancer mortality lies in the ability to detect tumors when they are still very small and can be treated promptly, with interventions that are generally less invasive than larger tumors and with better chances of recovery.
All this is more difficult when the diagnosis occurs at the onset of symptoms, because in these cases the tumors are on average much more advanced.
Prevenzione Serena also makes research possible: as part of the organized program, new technologies and strategies are being tested for increasingly effective screening.
In particular, for the mammographic screening, the Proteus Woman study, carried out in 13 regional centers from 2014 to 2017, evaluated the advantages and disadvantages of the use of tomo-synthesis (three-dimensional mammography) compared to 2d mammography, in the early detection of the tumor breast.
The study enrolled more than 70,000 women aged 46-68 participants in the prevention program who were randomly assigned to two study groups that compare the two screening methods. 30 thousand tomo-syntheses have been acquired and results are being analyzed.
The MyPeBS (My Personal Breast Cancer Screening) study, funded by the European Commission, which aims to recruit 85,000 women in Italy, France, Belgium, the United Kingdom and Israel, with the aim of testing a new personalized screening based on risk.
This strategy will be compared with the protocols currently in use to evaluate their effectiveness and feasibility in screening contexts in Europe. Individual risk will be defined based on personal and family medical history, breast density and DNA analysis. Prevention Serena will recruit 5 thousand women for MyPeBS in Turin in the next two years and the participants will be followed for four years.