Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Screening for Breast Cancer
USPSTF issues recommendation statement
The US Preventive Services Task Force (USPSTF) has issued updated recommendations on screening for breast cancer that recommend biennial screening mammography for women aged 50 to 74 years. (B recommendation). The statement is an update of the 2009 USPSTF recommendation and applies to asymptomatic women aged 40 years or older who do not have preexisting breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation. Other recommendations include:
• The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years. (C recommendation).
• The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older. (I statement)
• The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer. (I statement)
• The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging (MRI), DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement)
Citation: Siu AL, et al. Screening for breast cancer: US preventive services task force recommendation statement. [Published online ahead of print January 12, 2016]. Ann Intern Med. doi: 10.7326/M15-2886.
1. Women with an average risk of breast cancer should undergo regular screening mammography starting at age 45 years. (Strong Recommendation)
1a. Women aged 45 to 54 years should be screening annually. (Qualified Recommendation)
1b. Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually. (Qualified Recommendation)
1c. Women should have the opportunity to begin annual screening between the ages of 40 and 44 years. (Qualified Recommendation)
2. Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer. (Qualified Recommendation)
3. The ACS does not recommend clinical breast examination for breast cancer screening among average-risk women at any age. (Qualified Recommendation) —Neil Skolnik, MD
1. Oeffinger KC, Fontham ETH, Etzioni R, et al. Breast cancer screening for women at average risk. JAMA. 2015;314(15):SWK.
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Pregnancy History and Risk of Miscarriage, BMJ; ePub 2019 Mar 20; Magnus, et al
Ultrasonography Screening in Breast Cancer, JAMA Intern Med; ePub 2019 Mar 18; Lee, et al
Sedentary Behaviors & CVD Risk in Older Women, Circulation; 2019 Feb 19; Bellettiere, et al
USPSTF: Interventions to Avert Perinatal Depression, JAMA; 2019 Feb 12; US Preventive Services Task Force