Updated Recommendation for Breast Cancer Screening

The update of the U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for breast cancer in the general population has been published today in the Annals of Internal Medicine.

The USPSTF Recommends

• Against routine screening mammography in women aged 40-49 years
• Biennial (every two years) screening mammography for women between the ages of 50 and 74 years

Based on the USPSTF review, the current evidence is insufficient to assess benefits and harms of ...

• Screening mammography in women 75 years or older
• Clinical breast examination beyond screening mammography in women 40 years or older
• Either digital mammography or magnetic resonance imaging instead of film mammography as screening modalities for breast cancer

What Has Changed from the Previous Recommendations, and Why?

• Recommendations against universal screening mammography for women aged 40 to 49 years, based in part on an updated systematic review of screening mammography randomized, controlled trials that showed lower yield of reduced breast cancer mortality and higher false-postive results with screening in this population
• Recommendation of biennial screening mammography for women aged 50 to 69. Based on statistical models, annual versus biennial screening showed similar degree of breast cancer mortality reduction and similar likelihood of late-stage disease at diagnosis.
• Extension of screening mammography to women aged 70 to 74 years. Models estimate that approximately 2 additional breast cancer deaths are averted per 1000 women screen at this age.

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Reference:

1. U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2009;151:716-726.

2. Kerlikokowske K. Evidence-based breast cancer prevention: the importance of individual risk. Ann Intern Med 2009;151:750-752.