New Research Explores the Future of Personalised Breast Screening

A new paper published in Frontiers in Health Services explores how countries across Europe are considering ways to integrate personalised breast cancer risk assessment into routine healthcare.

The study, carried out as part of the BRIGHT project, examines how five European countries – Estonia, Portugal, Spain, Sweden and France – are implementing polygenic risk scores (PRS) to help identify women who may benefit from earlier and more personalised breast screening.

At Prevent Breast Cancer, we welcome this research. For many years, we have championed moving beyond the current one-size-fits-all approach to breast screening and towards a system that tailors screening according to a woman’s individual level of risk.

The NHS Breast Screening Programme currently invites most women for routine mammograms from the age of 50. While this programme saves thousands of lives every year, not every woman has the same level of breast cancer risk.

Some women are at much higher risk because of inherited gene mutations such as BRCA1 or BRCA2. Others may have no family history of breast cancer but still carry many small genetic variations known as single nucleotide polymorphisms (SNPs) that, when combined, can significantly increase their lifetime risk.

These tiny genetic differences can be combined into what is known as a polygenic risk score (PRS), helping identify women who may benefit from earlier or more frequent screening, potentially years before they would currently be invited through the NHS programme.

Prevent Breast Cancer has been at the forefront of research into personalised breast screening.

We helped pioneer this approach through the PROCAS 1 and PROCAS 2 studies, which demonstrated how combining genetic information with other risk factors can provide a far more accurate picture of an individual’s breast cancer risk than age alone. We have collaborated with Antegenes, specialists in polygenic risk scores (PRS), whose researchers are also involved in the BRIGHT project.

Building on this work, we have also been involved in ongoing personalised breast screening studies, including the BCanRAY study in Manchester and the Europe-wide MyPEBS trial, both of which are evaluating how personalised screening can be introduced safely, effectively and cost-effectively.

These studies recognise that no single test tells the whole story. Instead, they combine multiple sources of information, including family history, high-risk gene mutations such as BRCA1 and BRCA2, polygenic risk scores (PRS), breast density and established clinical risk assessment tools such as the Tyrer-Cuzick model.

Together, these factors provide a much more complete picture of an individual’s breast cancer risk and help identify who may benefit from earlier screening or preventative interventions.

One of the key messages from the BRIGHT study is that the science behind personalised screening is advancing rapidly, but successfully introducing it into healthcare requires much more than scientific evidence alone.

Researchers found that countries are progressing at different speeds. Estonia has already begun integrating PRS testing into routine healthcare, while others are introducing personalised screening through pilot programmes and research studies. Despite these different approaches, they identified common challenges, including developing clear clinical guidance, improving genetic literacy among healthcare professionals, strengthening digital infrastructure and ensuring health systems are ready to deliver personalised care.

The study highlights an important point: implementing personalised breast screening is not simply about introducing a new genetic test. It requires healthcare systems, technology and clinical practice to evolve together.

An ideal personalised screening programme would move away from treating every woman the same. Instead, each woman’s screening would reflect her individual level of risk, bringing together information from high-risk gene testing, polygenic risk scores (PRS), breast density and clinical risk assessment.

Women identified as being at higher risk could begin screening earlier and receive more intensive surveillance, such as MRI scans or more frequent mammograms. Those at lower risk may require less frequent screening, while women at average risk could continue with the current NHS programme. This approach has the potential to improve early diagnosis while making the best use of NHS resources.

We now have increasingly sophisticated tools to assess an individual’s breast cancer risk. However, introducing personalised screening across the NHS will require healthcare professionals to have the knowledge, skills and confidence to deliver personalised risk assessments and support women in understanding what their results mean. Ensuring the workforce is prepared for this shift is a key priority for Prevent Breast Cancer.

We believe personalised breast screening represents one of the most important advances in breast cancer prevention. By identifying women at increased risk earlier, we can offer tailored screening and preventative interventions before cancer develops.

This latest research demonstrates that personalised breast screening is moving closer to becoming a reality across Europe.