PhD defence Amarens Geuzinge
Breast cancer is the most common cancer in women. In the Netherlands, women aged 50 to 74 years are invited every two years for a mammogram to screen for breast cancer. Women who are at high risk of developing breast cancer due to a pathogenic variant in BRCA1/2 genes are offered MRI screening. However, more subgroups of women who have an increased risk of developing breast cancer may benefit from MRI screening as well but still undergo mammography screening. In this thesis the effectiveness of MRI screening for several risk groups was investigated. These risk groups consisted of women with a family history of breast cancer, women with a pathogenic variant in ATM, CHEK2 and PALB genes, and women with extremely dense breast tissue. Besides the use of randomized controlled trials, we used microsimulation modelling to investigated what the optimal screening interval and starting/stopping ages would be for these women. Furthermore, we conducted cost-effectiveness analyses and evaluated the preferences of women themselves.