Breast Cancer Screening Guidelines for Women
Breast Cancer Screening Guidelines for Women
Women aged 40 to 49 with average risk
Women aged 50 to 74 with average risk
U.S. Preventive Services Task
Force1 2016
American Cancer American College
Society2
of Obstetricians
2015
and
Gynecologists3
2011
International Agency for Research on
Cancer4 2015
American College American College of Radiology5 of Physicians6 2010
American Academy of
Family Physicians7
2016
The decision to Women aged 40 to Screening with Insufficient
start screening 44 years should mammography and evidence to
mammography in have the choice to clinical breast
recommend for or
women prior to age start annual breast exams annually. against screening.
50 years should be cancer screening
an individual one. with mammograms
Women who place if they wish to do
a higher value on so. The risks of
the potential
screening as well
benefit than the as the potential
potential harms benefits should be
may choose to considered.
begin biennial
screening between Women aged 45 to
the ages of 40 and 49 years should
49 years.
get mammograms
every year.
Screening with mammography annually.
Discuss benefits The decision to
and harms with start screening
women in good mammography
health and order should be an
screening with
individual one.
mammography Women who place
every two years if a a higher value on
woman requests it. the potential
benefit than the
potential harms
may choose to
begin screening.
Biennial screening Women aged 50 to Screening with For women aged Screening with
mammography is 54 years should mammography and 50 to 69 years, mammography
recommended. get mammograms clinical breast
screening with
annually.
every year.
exam annually. mammography is
recommended.
Women aged 55
years and older
For women aged
should switch to
70 to 74 years,
mammograms
evidence suggests
every 2 years, or
that screening with
have the choice to
mammography
continue yearly
substantially
screening.
reduces the risk of
death from breast
cancer, but it is not
currently
recommended.
Physicians should encourage mammography screening every two years in average-risk women.
Biennial screening with mammography.
U.S. Preventive Services Task
Force1 2016
American Cancer American College
Society2
of Obstetricians
2015
and
Gynecologists3
2011
International Agency for Research on
Cancer4 2015
American College American College of Radiology5 of Physicians6
2010
American Academy of
Family Physicians7
2016
Women aged 75 or older with average risk
Current evidence is Screening should Women should, in
insufficient to
continue as long as consultation with
assess the balance a woman is in good their physicians,
of benefits and health and is
decide whether or
harms of screening expected to live 10 not to continue
mammography in more years or
mammographic
women aged 75 longer.
screening.
years or older.
Not addressed.
Screening with Screening is not mammography recommended. should stop when life expectancy is less than 5 to 7 years on the basis of age or comorbid conditions.
Current evidence is insufficient to assess the balance of benefits and harms of screening with mammography.
Women with Current evidence is There is not
dense breasts insufficient to
enough evidence
assess the balance to make a
of benefits and recommendation
harms of adjunctive for or against
screening for
yearly MRI
breast cancer
screening.
using breast
ultrasonography,
magnetic
resonance imaging
(MRI), digital
breast
tomosynthesis
(DBT), or other
methods in women
identified to have
dense breasts on
an otherwise
negative screening
mammogram.
Insufficient evidence to recommend for or against MRI screening.
Insufficient evidence to recommend for or against screening.
In addition to mammography, ultrasound can be considered.
Not addressed.
Current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, MRI, DBT, or other methods.
Women at higher than average risk
U.S. Preventive Services Task
Force1 2016
Women with a parent, sibling, or child with breast cancer are at higher risk for breast cancer and thus may benefit more than average-risk women from beginning screening in their 40s.
American Cancer American College
Society2
of Obstetricians
2015
and
Gynecologists3
2011
International Agency for Research on
Cancer4 2015
American College American College of Radiology5 of Physicians6
2010
American Academy of
Family Physicians7
2016
Women who are at For women who Evidence suggests For BRCA1 or
Not addressed.
high risk for breast test positive for that screening
BRCA2 mutation
cancer based on BRCA1 or BRCA2 (mammography carriers, untested
certain factors
mutations or have and MRI) at an family members of
(such as having a a lifetime risk of earlier age may be BRCA1 or BRCA2
parent, sibling, or 20% or greater, beneficial.
mutation carriers,
child with a BRCA screening should
and women with a
1 or BRCA2 gene include twice-
lifetime risk of 20%
mutation) should yearly clinical
or greater (based
get an MRI and a breast exams,
on family history),
mammogram every annual
screening should
year.
mammography,
include annual
annual breast MRI,
mammography and
and breast self-
annual MRI starting
exams.
by age 30 years
but not before age
For women who
25 years.
received thoracic
irradiation between
For women with a
ages 10 and 30
history of chest
years, screening
irradiation between
should include
the ages of 10 and
annual
30 years, annual
mammography,
mammography and
annual MRI, and
annual MRI starting
screening clinical
8 years after
breast exams
treatment
every 6 to 12
(mammography not
months beginning
recommended
8 to 10 years after
before age 25).
radiation treatment
or at age 25 years.
Not addressed.
U.S. Preventive Services Task
Force1 2016
American Cancer American College
Society2
of Obstetricians
2015
and
Gynecologists3
2011
International Agency for Research on
Cancer4 2015
Additional Current evidence is Women should be Not addressed.
issues
insufficient to
familiar with the
relevant for all assess the benefits known benefits,
women
and harms of
limitations, and
digital breast
potential harms
tomosynthesis
associated with
(DBT) as a primary breast cancer
screening method screening. They
for breast cancer. should also be
familiar with how
their breasts
normally look and
feel and report any
changes to a
health care
provider right
away.
Not addressed.
American College American College of Radiology5 of Physicians6
2010
American Academy of
Family Physicians7
2016
Not addressed.
Annual mammography, MRI, tomosynthesis, or regular systematic breast self-exam are not recommended.
Recommends against clinicians teaching women breast self-exams. Current evidence is insufficient to assess the benefits and harms of clinical breast exams and DBT.
1Siu AL; U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine 2016;164(4):279?296.
2Oeffinger KC, Fontham ET, Etzioni R, Herzig A, Michaelson JS, Shih YC, Walter LC, Church TR, Flowers CR, LaMonte SJ, Wolf AM, DeSantis C, Lortet-Tieulent J, Andrews K, Manassaram-Baptiste D, Saslow D, Smith RA, Brawley OW, Wender R; American Cancer Society. Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA 2015;314(15):1599?1614.
3American College of Obstetricians-Gynecologists. Practice bulletin no. 122: Breast cancer screening. Obstetrics and Gynecology 2011;118(2 Pt 1):372?382.
4Lauby-Secretan B, Loomis D, Straif K. Breast-cancer screening--viewpoint of the IARC Working Group. New England Journal of Medicine 2015;373(15):1478? 1479.
5Lee CH, Dershaw DD, Kopans D, Evans P, Monsees B, Monticciolo D, Brenner RJ, Bassett L, Berg W, Feig S, Hendrick E, Mendelson E, D'Orsi C, Sickles E, Burhenne LW. Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. Journal of the American College of Radiology 2010;7(1):18?27.
6Wilt TJ, Harris RP, Qaseem A; High Value Care Task Force of the American College of Physicians. Screening for cancer: advice for high-value care from the American College of Physicians. Annals of Internal Medicine 2015;162(10):718?725.
7American Academy of Family Physicians. Summary of recommendations for clinical preventive services. 2016. Available from: [PDF-574KB].
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