Current screening for breast cancer is well established relying mainly on imaging, using mammograms, ultrasounds, and for younger women, MRIs; all techniques which are limited to identifying visible tumours. There are no standard screening programmes for ovarian cancer. Women known to be at high risk may be offered routine ultrasounds with a blood test for CA125 or some make a difficult decision to have their ovaries removed to reduce their risk.
Some blood-based markers associated with cancer (including a form of DNA) have been identified in research and are now in widespread use in studies of advanced disease, and in monitoring recurrences where levels of these markers are detectable and considered high. Being able to detect these same markers at low levels, while challenging, could mean applying this approach to detecting early disease.
Women at increased risk of breast and ovarian cancer, including BRCA1/2 carriers, will be a valuable group of people for investigating and evaluating early detection strategies that could have the potential to be used as part of a screening programme.
Some of the women on the EMBRACE study will be eligible for this early detection programme. Their participation will involve the same components as previously mentioned however their bloods would be collected annually, while eligible (risk of breast and or ovarian cancer ongoing), in addition to the 2, 5 and 10 year follow up bloods. Blood samples will only be looked at following a cancer diagnosis to evaluate whether low levels of cancer blood markers could be found leading up to that diagnosis, and at an earlier stage than through the current screening techniques or the patient’s symptoms.