A national survey highlights primary care physician (PCP) breast cancer screening recommendations in the setting of guideline changes and differences. The research letter was published in JAMA Internal Medicine.1

Professional societies such as the American Cancer Society (ACS), the US Preventive Services Task Force (USPSTF), and the American Congress of Obstetricians and Gynecologists (ACOG) continue to differ in their recommendations on when to start, the optimal interval, and when to discontinue breast cancer screening with mammography.

Archana Radhakrishnan, MD, of Johns Hopkins University and colleagues, sought to better understand physician recommendations for breast cancer given recent guideline changes and differing recommendations by professional societies.  

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The study included a survey of PCPs that provide care to women 40 years of age or older and included internal medicine, family medicine, and gynecology. Physicians were surveyed on if they typically recommend routine breast cancer screening without a family history of breast cancer in various age groups and intervals.

The study had a 52% response rate and respondents were more often white (70.6%) male (54.6%) physicians.  

Breast cancer screening was recommended for women ages 40 to 44 years, 45 to 49 years, and 75 years of age or older by 81%, 88%, and 67% of responding physicians, respectively. Annual screening was recommended in the same age groups 62.9%, 66.7%, and 52.3%, respectively. Gynecologists were more likely to recommend breast cancer screening for women of all age groups compared to internal medicine or family medicine physicians (P < .001).

Overall, 26% of the responding physicians reported trusting the ACOG guidelines the most compared with 23.8% for ACS guidelines and 22.9% for USPSTF guidelines. Physicians who reported trusted ACOG or ACS guidelines more than the USPSTF guidelines were more likely to recommended screening for breast cancer at a younger age.1


1. Radhakrishnan A, Nowak SA, Parker AM, et al. Physician Breast Cancer Screening Recommendations Following Guideline Changes: Results of a National Survey. JAMA Intern Med. 2017. [Epub ahead of print] doi: 10.1001/jamainternmed.2017.0453