ACS: Screen Later, Less Often for Breast Cancer

Annual mammography screening should be conducted in women between the ages of 45 and 54 years old, according to updated guidelines from the American Cancer Society (ACS).

The new guidelines come as an update to the 2003 breast cancer screening guideline for women at average risk for breast cancer, and were written based on a systematic review of available evidence and a supplemental analysis of mammography registry data.
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The major difference found within the update is the shift from annual mammography in women starting at age 40 and continuing for the rest of their lives to annual screening only between the ages of 45 and 54, then biannual screening for as long as the women have a life expectancy of at least 10 years.

The new guidelines also note that evidence does not support the use of routine clinical breast examination as a screening method for women at average risk for breast cancer.

The ACS cites the heightened risk of false-positive findings associated with a greater number of mammograms, which result in patients being recalled for additional imaging and, in some cases, for biopsy, when the majority of these women will have benign findings, as a key reason for the shift in recommendations.  

“In conclusion, the ACS recommendations are made in the context of maximizing reductions in breast cancer mortality and reducing years of life lost while minimizing the associated harms among the population of women in the United States.”

“The intention of this new guideline is to provide both guidance and flexibility for women about when to start and stop screening mammography and how frequently to be screened for breast cancer.”

—Michael Potts

Reference:

Oeffinger KC, Fontham ETH, Etzioni R, et al. Breast cancer screening for women at average risk. JAMA. 2015;314(15):1599-1614.