USPSTF guidelines for breast cancer screening

On April 20, 2015, the U.S. Preventive Services Task Force (USPSTF) released its draft guidelines for breast cancer screening.

The USPSTF recommends biennial screening mammography for women ages 50 to 74 years.

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.

•   For women at average risk for breast cancer, most of the benefit of mammography will result from biennial screening during ages 50 to 74 years. Of all age groups, women ages 60 to 69 years are most likely to avoid a breast cancer death through mammography screening. Screening mammography in women ages 40 to 49 years may reduce the risk of dying of breast cancer, but the number of deaths averted is much smaller than in older women and the number of false-positive tests and unnecessary biopsies are larger.

•   All women undergoing regular screening mammography are at risk for the diagnosis and treatment of noninvasive and invasive breast cancer that would otherwise not have become a threat to her health, or even apparent, during her lifetime (known as “overdiagnosis”). This risk is predicted to be increased when beginning regular mammography before age 50 years.

•   Women with a parent, sibling, or child with breast cancer may benefit more than average-risk women from beginning screening between the ages of 40 and 49 years.

•    The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women age 75 years and older.

•     The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of tomosynthesis (3-D mammography) as a screening modality for breast cancer.

This recommendation applies to asymptomatic women age 40 years and older who do not have pre-existing 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 (such as a BRCA mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age.