A telemedicine app for preventive medicine, genetic risk, cancer pharmacoprevention and follow up: a tool for cancer specialists and patients using smartphone, PC and tablet. Development of BreastApp

Breast cancer is the most common cancer in women, with a peak incidence between the ages of 50 and 69. The introduction of screening programs, the effectiveness of preventive pre- and post-operative therapies, and the establishment of Breast Units have led to a progressive reduction in the mortality of women affected by this disease, with a reduction in cancer-specific mortality of 18%. The reduction in mortality among patients with breast cancer has increased the prevalence of the disease, and with it, the number of women who annually require frequent hospital visits for specialist follow up. Follow-up involves clinical and instrumental checks, monitoring of post-operative treatment toxicities, lifestyle and weight management, as well as updating the family tree to identify potential mutations predisposing to cancer development. The suspension of scheduled visits and exams due to the COVID-19 health emergency limited access to hospitals for women in follow up for breast cancer, causing significant inconvenience for patients, dangerous diagnostic delays, and generating a huge backlog of work for healthcare personnel. In this context, the idea for BreastApp emerged. BreastApp is a multi-platform application that allows patients to monitor symptoms related to the disease, potential recurrence, and treatments; track weight, nutrition, and lifestyle; and continuously build and update their family tree in order to detect possible hereditary breast cancer syndromes. Aiming at the management of oncological follow-up for patients with breast cancer, BreastApp represents a valuable tool not only for the patient but especially for the specialists involved in Breast Units. Direct data sharing allows for: - a constant and telematic support for patients, - a useful tool for clinicians in monitoring follow-up patients based on Patient Reported Outcomes (PROs). The analysis of exposures (e.g., dietary or environmental factors) and genetic-molecular data can be integrated and used for the development of population studies aimed at identifying new prognostic and predictive factors for treatment response and the development of treatment-related toxicities in women who have undergone breast cancer surgery. The DEMO of BreastApp, thanks to the collaboration with the company Net4Market and funding from Fondazione Cariparma, is ready for use, which is expected to begin in March 2025 at the Breast Unit of the University Hospital of Parma. The results of the pilot project will indicate the possibility of expanding the product to other types of cancer (such as colon or prostate cancer), as well as chronic diseases like diabetes orhypertension, leveraging the same benefits and advantages.