Recommendations on breast cancer screening and prevention in the context of implementing risk stratification: impending changes to current policies.

J Gagnon, E Lévesque, F Borduas, J Chiquette, C Diorio, N Duchesne, M Dumais, L Eloy, W Foulkes, N Gervais, L Lalonde, B L'Espérance, S Meterissian, L Provencher, J Richard, C Savard, I Trop, N Wong, B M Knoppers, J Simard

In recent years, risk stratification has sparked interest as an innovative approach to disease screening and prevention. The approach effectively personalizes individual risk, opening the way to screening and prevention interventions that are adapted to subpopulations. The international perspective project, which is developing risk stratification for breast cancer, aims to support the integration of its screening approach into clinical practice through comprehensive tool-building. Policies and guidelines for risk stratification-unlike those for population screening programs, which are currently well regulated-are still under development. Indeed, the development of guidelines for risk stratification reflects the translational aspects of perspective. Here, we describe the risk stratification process that was devised in the context of perspective, and we then explain the consensus-based method used to develop recommendations for breast cancer screening and prevention in a risk-stratification approach. Lastly, we discuss how the recommendations might affect current screening policies.