The American Cancer Society (ACS) released its updated guidelines for breast cancer screening in women at average risk for developing the disease.
These latest guidelines update those established in 2003. The new guidelines are explained in a report published in JAMA.
Multiple studies have validated the effectiveness of screening mammography in women age 40 to 69 years to reduce breast cancer deaths. Furthermore, some evidence supports continuing screening in select women age 70 years and older.
After a systematic evidence review of the literature on breast cancer screening and a supplemental analysis of mammography registry data, ACS formulated this update to its breast cancer screening guidelines based on the quality of the evidence, incorporating values and preferences, regarding benefits and harms.
Initiating screening mammography at a younger age increases the total number of mammograms in a woman’s lifetime, thereby increasing the risk of false-positive results.
The evidence was not sufficient to confidently estimate the risk of overdiagnosis, however. The evidence did support screening premenopausal women annually vs biennially, but not the use of clinical breast examination as a screening method.
For women with an average risk of developing breast cancer, ACS recommends annual screening mammography beginning at age 45 to 54 years, and transitioning to biennially at age 55 years and older.
Despite this change, ACS guidelines advocate providing the opportunity for annual screening mammography for women age 40 to 44 years, and to continue annual screenings in women older than 55 years.
Screening mammography should continue as long as the woman’s overall health is good and life expectancy is more than 10 years. ACS does not recommend clinical breast examination for women at any age.
The ACS guidelines are based on evidence in the literature for breast cancer screening in women at average risk of developing the disease. Physicians and patients should consider these recommendations in their discussions about breast cancer screening.
1. Oeffinger KC, Fontham ET, Etzioni R, et al. Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA. 2015;314(15):1599-1614. Doi:10.1001/jama.2015.12783.