Swedish Mammography Risk Stratified Trial - SMART

The aim of breast cancer screening is early detection of breast cancers. Mammography screening is so far the only proven method that reduces mortality from breast cancer.

Mortality from breast cancer is 20-40% lower in screened women compared to non-screened women.Among women attending the Swedish Mammography Screening Program approximately every third breast cancers is diagnosed with breast cancer in the interval between two screens, a so-called interval cancer.

The interval cancers could be either masked by high mammographic density, missed at the previous screening round or fast growing and actually developing in between two screening rounds.

Interval cancers are more common in women with dense breasts and are considered more aggressive than screen detected cancers.The risk of breast cancer and the possibility to detect a cancer differs profoundly between women.

Women with mammographically dense breasts have an increased risk of breast cancer and the possibility to diagnose a prevalent breast is reduced due to “masking”.

Women with dense breast are more likely to be diagnosed with an interval cancer then women with non-dense breasts.The aim of SMART, The Swedish Mammography Risk stratified Trial, is to test the effectiveness of individualised breast cancer screening.

In short - does an individualised screening program identify cancers at an earlier, curable stage, compared to the current one-fits-all approach?