Am Fam Physician. 2016 Apr 15;93(8):711-712.
Related Editorial: Counseling Women About Breast Cancer Screening.
Related USPSTF: Screening for Breast Cancer: Recommendation Statement.
Key Points for Practice
• Routine screening with mammography should be initiated at 45 years of age in women at average risk.
• For women 55 years and older, biennial screening is the preferred approach, with the option to screen each year.
• Annual screening mammography should be offered to patients between 40 and 44 years of age.
• Clinical breast examination is not recommended as an approach to screening for breast cancer.
From the AFP Editors
Breast cancer remains a leading cause of cancer-related mortality among women in the United States, even as early detection and treatment advances have helped contribute to a decline in deaths from breast cancer in recent decades. Mammography is an important screening tool, and the publication of long-term follow-up studies has led to a better understanding of the impact its use has on patient health.
The American Cancer Society (ACS) organized an interdisciplinary guideline development group to review the available evidence on breast cancer mortality, quality of life, life expectancy, false-positive findings, overdiagnosis, and overtreatment, and to update their 2003 guideline on breast cancer screening in average-risk women. The 2015 recommendations emphasize the need to inform patients of the balance of potential harms and benefits of screening and engage in shared decision making.
In women who are at average risk of breast cancer, routine screening with mammography should be initiated at 45 years of age. Screening should continue on an annual basis until 54 years of age. For women 55 years and older, biennial screening is the preferred approach, with the option to screen each year. Annual screening mammography should be offered to patients between 40 and 44 years of age, although the five-year absolute risk of breast cancer is lower in this age group than for women older than 45 years.
The previous guideline directed clinicians to screen women annually starting at 40 years of age, and continue screening throughout the patient's lifetime unless the patient was in poor health or would not be able to withstand treatment for breast cancer.
Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.
This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.
A collection of Practice Guidelines published in AFP is available at http://www.aafp.org/afp/practguide.
Copyright © 2016 by the American Academy of Family Physicians.
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