Recommendation parameter	USPSTF and AAFP	ACOG	ACR	ACS	NCCN
Breast examination
Breast self-examination	Recommends against teaching patients	Encourages breast self-awareness	—	Encourages breast self-awareness	Encourages breast self-awareness
Clinical breast examination	Insufficient evidence	May be offered every 1 to 3 years from 25 to 39 years of age and then annually	—	Not recommended	Recommends every 1 to 3 years from 25 to 39 years of age and then annually
Mammography (by age)
40 to 44 years	Individual decision	Offer annual or biennial (individual decision)	Annual	Offer annual (individual decision)	Annual
45 to 49 years	Individual decision	Offer annual or biennial (individual decision)	Annual	Annual	Annual
50 to 54 years	Biennial	Annual or biennial	Annual	Annual	Annual
55 to 74 years	Biennial	Annual or biennial	Annual	Biennial, option to continue annually	Annual
When to stop mammography	Insufficient evidence for continued screening in women 75 years and older	Shared decision-making in women 75 years and older	Discontinue when life expectancy is < 5 to 7 years	Discontinue when life expectancy is ≤ 10 years	Discontinue when life expectancy is ≤ 10 years
Special considerations
Adjunct MRI for high-risk women	Insufficient evidence	Offer annual mammography and MRI starting at 30 years	Annual mammography and MRI starting at 30 years	Offer annual mammography and MRI starting at 30 years	Annual mammography, clinical breast examination every six to 12 months, consider annual MRI starting at 30 years
Women with dense breasts	Insufficient evidence	Insufficient evidence	Consider ultrasonography plus mammography	Insufficient evidence	Counsel on risks and benefits of supplemental screening