Breast cancer screening: 25 questions to consider for improvements

Socrates He argued that knowledge is not transmitted, but rather It is built through the questionHis method, the maieuticsIt consisted of questioning, re-questioning, and guiding thought until the most solid ideas emerged. were to “be born” of themselves.

Perhaps that is also the best starting point for Let's reflect today on breast cancer screening.
Because beyond the progress achieved, their current model It remains susceptible to improvement.
And to improve, first you have to ask.

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Access and participation

• Are we making screening accessible enough to women?
• Could participation increase if We bring the mobile units closer to the municipalities or to the workplaces, as is done in Japan?
• What real barriers persist—time, travel, schedules, appointments—and how do we measure them?
• If we were to deploy mobile units, in which areas would they have the greatest impact?

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Frequency and individual risk

• Does it make sense to maintain the same frequency for all women?
• In what cases would make sense review annually and in which could be spaced out plus?
• Which variables should be given more weight: age, breast density, family history, other factors?
• Can we communicate a custom calendar without causing confusion?

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Interval cancers

• What do we learn from the tumors that appear between two rounds screening?
• Could we detect earlier Are some of those cases being monitored more dynamically?
• What combination of frequency, testing, and prioritization Would it offer a better balance between benefit and risk?

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Artificial intelligence

• Where adds more value AI: in pre-reading, prioritization, virtual double-reading, or risk triage?
• To what extent can reduce bottlenecks without compromising diagnostic accuracy?
• How does We validate and audit How can their results strengthen human clinical judgment?
• Could AI suggest custom periodicities based on the observed risk?

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Circuits, protocols and times

• Our care pathways Are they sufficiently agile and homogeneous?
• Where are the delays concentrated, and what time indicators should be monitored?
• Do they work effectively? expressways for suspected cases?
• We can differentiate processes according to the clinical profile without complicating management?

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Equity and communication

• Do they persist participation gaps according to territory, socioeconomic level or language?
• What communication strategies they achieve greater adherence to the programs?
• Are we explaining the benefits and limitations of the screening?

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Continuous evaluation and improvement

• What indicators—mortality, stage at diagnosis, interval rates, response times—should be published periodically?
• How often is the program reviewed, and who participates in that review?
• What international experiences would be advisable pilot before generalizing?

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Seeking answers to the questions

We are working on a report that seeks precisely that: to offer well-founded answers to these types of questions, with data, evidence and a critical and constructive perspective.