Pink October: Breast Cancer Awareness Month

Every October, the international medical community mobilizes around Pink October, an awareness campaign aimed at increasing the visibility of breast cancer, promoting early detection, improving treatments and supporting research.

In Switzerland, despite a high-quality healthcare system, disparities still exist in access to screening and treatment. The Imaging and Diagnostic Center (CID) in Lausanne plays a vital role in addressing this issue by offering high-precision imaging examinations and integrating the latest innovations in breast cancer detection.

All women are potentially affected by breast cancer screening, regardless of their age.

Screening methods are adapted according to the individual risk level.

Women without particular risk factors are generally considered to be at average risk and are targeted by cantonal programs between the ages of 50 and 74.

Conversely, women at high risk—particularly those with a family history of breast cancer, genetic mutations such as BRCA1 or BRCA2, high breast density, or prior chest radiation therapy—benefit from personalized care. This approach may include earlier screening, more frequent screening, and additional tests such as breast ultrasound or MRI.

In Switzerland, screening mammography is generally offered every two years to women aged 50 to 74 as part of organized cantonal programs. For women at higher risk, the screening protocol is adjusted according to international recommendations and available cantonal resources. This may involve earlier screening, more frequent checkups, and the use of additional imaging techniques.

Benign prostatic hyperplasia (BPH) is extremely common after the age of 50 and can become complicated in the summer due to dehydration, heat, and lifestyle changes. Urinary problems (pollakiuria, nocturia, dysuria) often worsen during travel or summer activities. Prolonged exposure to heat and changes in hydration can promote acute urinary retention, urinary tract infections, and, in some cases, prostatic infectious complications.

At the same time, prostate cancer remains the most common cancer in men in Switzerland. PSA testing is the first level of screening, but its sensitivity and specificity are limited. Today, multiparametric prostate MRI has become the gold standard examination whenever there is any doubt: it allows lesions to be located and characterized, reduces unnecessary biopsies, and precisely targets necessary biopsies.

Summer is a particularly relevant time to plan this type of preventive assessment in men at risk, in order to avoid possible urological complications during the holidays and to anticipate the management of detected prostate abnormalities.

Several international and Swiss studies reinforce the value of organized screening. The European Breast Guidelines, established by the European Commission's Joint Research Centre, recommend systematic screening every two years for women aged 50 to 69.

A study conducted in the canton of Fribourg in 2019 demonstrated that women participating in organized screening had a higher rate of in situ cancers and underwent mastectomies less often.

Further research, particularly on the use of artificial intelligence in mammography, indicates that these tools can improve detection without significantly increasing false positives.

From a technological standpoint, breast imaging has seen major advances. Digital mammography is now the standard method for screening. It can be complemented by breast tomosynthesis, a thin-slice imaging technique that improves detection, particularly in women with dense breasts.

Breast ultrasound is used as a complementary examination to clarify certain images or to explore specific areas. Breast MRI, on the other hand, is reserved for high-risk women or complex diagnostic cases.

Image-guided percutaneous biopsies (ultrasound, mammography or MRI) allow for an accurate histological diagnosis, thus avoiding unnecessary surgical interventions.

Artificial intelligence (AI) is playing an increasing role in the interpretation of mammograms. Software such as ProFound AI or Transpara is already being used in some Swiss centers.

These tools enable the detection of more cancers by acting as a second reader, highlighting suspicious abnormalities, and automatically assessing the risk of malignancy. They help reduce reading errors, prioritize cases, and improve the efficiency of radiologists.

In Switzerland, projects like LesionLens are developing specific AI for the interpretation of dynamic breast MRIs, paving the way for more personalized medicine.

At CID Lausanne, the patient journey is designed to be both medically rigorous and respectful of individual needs. When a patient makes an appointment, she is welcomed for an initial consultation including a detailed medical history and a clinical examination.

Imaging is then performed as needed: digital mammography with or without tomosynthesis, ultrasound, or MRI. The examinations are analyzed by experienced radiologists, assisted where necessary by AI tools.

If an abnormality is detected, a biopsy can be performed as soon as possible. Once the diagnosis is established, the patient is referred for multidisciplinary care in collaboration with regional oncology teams.

Let's take the example of Ms. N., aged 52, with no family history of breast cancer. During a self-examination, she discovers a small lump in her right breast. She quickly consults her gynecologist, who refers her to the CID Lausanne. A mammogram followed by tomosynthesis reveals a suspicious opacity accompanied by microcalcifications. An ultrasound confirms the presence of a lesion, and AI-assisted analysis reinforces the suspicious nature of the image.

A guided biopsy was performed, confirming an intermediate-grade invasive ductal carcinoma. Conservative surgical management, followed by radiotherapy, resulted in a favorable outcome. This case illustrates the importance of early detection and advanced technology in the management of breast cancer.