Breast Cancer Screening: Common Questions and Answers
Am Fam Physician. 2021 Jan 1;103(1):33-41.
Patient information: See related handout on mammogram screening for breast cancer, written by the authors of this article.
Author disclosure: No relevant financial affiliations.
- What Are the Risk Factors for Breast Cancer?
- How Can Physicians Estimate the Risk of Developing Breast Cancer?
- Does Screening Mammography Reduce Breast Cancer–Related Mortality?
- What Are the Potential Harms of Breast Cancer Screening?
- What Are the Screening Recommendations for Patients at Average Risk?
- At What Age Should Breast Cancer Screening Be Discontinued?
- What Are the Screening Recommendations for Patients at Increased Risk?
- Does Supplemental Imaging Have a Role in Evaluating Dense Breasts?
Breast cancer is the most common nonskin cancer in women and accounts for 30% of all new cancers in the United States. The highest incidence of breast cancer is in women 70 to 74 years of age. Numerous risk factors are associated with the development of breast cancer. A risk assessment tool can be used to determine individual risk and help guide screening decisions. The U.S. Preventive Services Task Force (USPSTF) and American Academy of Family Physicians (AAFP) recommend against teaching average-risk women to perform breast self-examinations. The USPSTF and AAFP recommend biennial screening mammography for average-risk women 50 to 74 years of age. However, there is no strong evidence supporting a net benefit of mammography screening in average-risk women 40 to 49 years of age; therefore, the USPSTF and AAFP recommend individualized decision-making in these women. For average-risk women 75 years and older, the USPSTF and AAFP conclude that there is insufficient evidence to recommend screening, but the American College of Obstetricians and Gynecologists and the American Cancer Society state that screening may continue depending on the woman's health status and life expectancy. Women at high risk of breast cancer may benefit from mammography starting at 30 years of age or earlier, with supplemental screening such as magnetic resonance imaging. Supplemental ultrasonography in women with dense breasts increases cancer detection but also false-positive results.
Breast cancer is the most common nonskin cancer in women and accounts for 30% of all new cancers in the United States.1 From 2001 to 2016, more than 2.3 million women in the United States were diagnosed with breast cancer.2 The incidence of breast cancer increases after 25 years of age, peaking between 70 and 74 years.2 Approximately one in eight women will develop invasive breast cancer (12.8% lifetime risk).1
SORT: KEY RECOMMENDATIONS FOR PRACTICE
AAFP = American Academy of Family Physicians; ACS = American Cancer Society; USPSTF = U.S. Preventive Services Task Force.
A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to https://www.aafp.org/afpsort.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
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