Improving breast cancer screening
By: Elizabeth Garel, Cancer Care Ontario
Anna Chiarelli has been studying breast cancer screening in one way or another since joining Cancer Care Ontario in 1996.
More than 20 years later, she is beginning a new phase of research. Her latest project focuses on improving personalized risk assessment, using a combination of genetic profiling and other breast cancer risk factors. Chiarelli is working with Assistant Professors Jennifer Brooks and Meghan Walker in the Division of Epidemiology on the project that is funded by Genome Quebec.
The goal, says the Ontario Breast Screening Program’s provincial scientific lead, is to offer risk-based prevention and screening.
“At the moment, we screen all women within a certain age range in a ‘one-size-fits-all’ approach. Tailoring prevention and screening recommendations based on individual risk will enable earlier detection and treatment of breast cancer, saving lives and providing health and socio-economic benefits,” she says.
Chiarelli is also examining issues around delayed diagnosis, both the clinical implications and the reasons for any delay. “We want to ensure the clinical pathway to determining a diagnosis of breast cancer is timely and well-coordinated. Our studies show that diagnosis is faster for women who are seen at breast assessment centres.”
An epidemiologist by training, she says she “fell into” her speciality as the Ontario Breast Screening Program (OBSP) was the only screening program offered by Cancer Care Ontario when she joined the organization.
“My job initially was to evaluate the program, but I soon discovered that the OBSP’s incredibly comprehensive database offered near-endless opportunities to explore new avenues of research,” she says.
Chiarelli is perhaps best known for her landmark 2013 research which showed that digital mammography systems using computed radiography was less effective at detecting breast cancer than direct radiography. The study led to the installation of the more-effective mammography machines across Ontario.
“When the findings from my research can be applied to a program and I can see that the net results are helping people, that’s very rewarding,” she says.
Anna M Chiarelli MHSc, PhD, is Senior Scientist, Prevention and Cancer Control, and Provincial Scientific Lead with the Ontario Breast Screening Program, Cancer Care Ontario. She is also a Professor with the Dalla Lana School of Public Health, University of Toronto.