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WP9.5 has achieved its goals and is preparing 2 publications and has submitted 3 conference abstracts on the matter.

Risk-based breast cancer screening (RBBCS) is an emerging approach aimed at tailoring screening strategies to individual risk profiles. As part of the EUCanScreen initiative a Delphi process was conducted to assess expert consensus on the current state of evidence and implementation needs for RBBCS.

We conducted a systematic review of completed and ongoing (ong) studies on RBS worldwide. Eligible studies were identified through PubMed, ClinicalTrials.gov and a structured survey within the EUCanScreen network. Data were reviewed by 3 independent investigators (PROSPERO 616967).   

A two-round Delphi survey was carried out between May and June 2025 among European experts in risk-stratified screening. Fourteen evidence-based statements covering effectiveness, acceptability, harms, feasibility, and implementation challenges were evaluated. Consensus was defined as ≥85% agreement.

Conclusions

While cohort studies have demonstrated the impact of screening escalation among BRCA1/2 carriers, other RBS studies have not yet reached a sufficient level of evidence (LoE) to change practices. Major escalation and de-escalation studies in the general population are awaited in the upcoming years.

The Delphi process identified strong expert consensus on key aspects of RBBCS, while highlighting persistent evidence gaps in implementation, acceptability and risk threshold definition. These findings emphasize the need for real-world data and support the development of evidence-informed risk-based screening strategies across Europe.

Authors 

Maria Agustina Ipina, Suzette Delaloge, Gustave Roussy
Paola Mantellini ISPRO