Abenaa M. Brewster, MD, MHS

Improving the precision and personalization of breast cancer screening

Impact

Annual breast cancer screening is an important component of preventive healthcare for women. Mammograms, the gold standard for breast cancer screening, are imperfect and less helpful for fast-growing breast cancers, like the estrogen receptor (ER)-negative subtypes. To improve the precision of breast cancer screening, and increase capacity for detecting breast cancer early, Dr. Brewster and her team are working to develop a new liquid biopsy technique to detect cancer with a simple blood-based test. Ideally, this test would allow for more personalized screening, where someone with a positive blood test can be offered more frequent screening—including breast MRI—while someone with a negative blood test would be safely advised to have less frequent screening mammograms or no screening at all. Further, her team is evaluating patients’ perceptions and preferences for this new method of breast cancer detection to evaluate potential barriers.

Progress Thus Far

The team has focused this year on screening in women with DCIS, who have an elevated risk of developing invasive breast cancer. As a result of the elevated risk, women with DCIS undergo additional screening, preventive therapy, and often surgical intervention. Many are overtreated and never develop invasive breast cancer. Dr. Brewster and her team plan to investigate genomic similarities between DCIS and subsequent invasive breast cancer and have retrieved tumor tissue samples from patients with DCIS who went on to develop invasive breast cancer. Those samples will be analyzed to identify key genes that may contribute to disease progression. They also developed a survey to assess perceptions and preferences for liquid biopsy screening among women with DCIS.

What’s next

Dr. Brewster and her team will perform analyses on blood samples from women who went on to develop breast cancer to evaluate a new liquid biopsy test they developed that uses AI to identify protein fragments in the blood. This analysis will help establish whether the protein fragment-based biomarkers are promising for the early detection of breast cancer. The results from these studies have the potential to personalize breast cancer screening by identifying women who may benefit from additional imaging and reducing unnecessary screening in those with a negative biomarker result.