New guideline shows that majority of average-risk women with no symptoms will benefit from mammography every other year beginning at age 50
Average-risk women, between the ages of 50 and 74, who have no symptoms for breast cancer should undergo breast cancer screening with mammography every other year. these are the recommendations of a new evidence-based guidance statement from the American College of Physicians (ACP).
The statement was published recently in the Annals of Internal Medicine.
ACP’s guidance statement does not apply to patients with prior abnormal screening results or to higher risk populations, such as women with a personal history of breast cancer or a genetic mutation known to increase risk.
Every other year mammography screening results in no significant difference in breast cancer mortality when compared to annual screening but substantially reduces screening harms. Women screened annually receive more abnormal results that do not represent an actual breast cancer diagnosis
“Beginning at age 40, average-risk women without symptoms should discuss with their physician the benefits, harms, and their personal preferences of breast cancer screening with mammography before the age of 50,” said ACP President Dr. Ana María López, who is also a medical oncologist. “The evidence shows that the best balance of benefits and harms for these women, which represents the great majority of women, is to undergo breast cancer screening with mammography every other year between the ages of 50 and 74.”
Every other year mammography screening results in no significant difference in breast cancer mortality when compared to annual screening but substantially reduces screening harms. Women screened annually receive more abnormal results that do not represent an actual breast cancer diagnosis than women screened every other year (7.0% vs. 4.8%). These false-positive findings result in biopsies and surgeries that would otherwise not have been necessary.
About 20 percent of women diagnosed with breast cancer over a 10-year period will be overdiagnosed and likely overtreated. Overdiagnosis means a woman is diagnosed with a breast cancer that would not have made her sick or led to her death if not diagnosed or treated (overtreatment).
In an accompanying editorial, Joann G. Elmore, MD, MPH, and Christoph I. Lee, MD, MS, wrote: “The results of [ACP’s] assessment are 4 guidance statements that provide clarity and simplicity amidst the chaos of diverging guidelines.”
