Updated recommendations for breast cancer screening

Abstract

Purpose of review: To describe the rationale behind the new recommendations for breast cancer screening issued by the U.S. Preventive Services Task Force (USPSTF).

Recent findings: The USPSTF reviewed new summary evidence provided by the Oregon Evidence-based Practice Center and the Cancer Intervention Surveillance and Modeling Network about benefits and harms including radiation exposure and the likelihood of false-positive testing, unnecessary biopsies and treatments that may not impact overall breast cancer mortality.

Summary: The USPSTF concluded maximal benefit in breast cancer mortality with least harms can be achieved with biennial mammography screening commenced at age 50 and continuing until age 74 years. A small additional benefit could be realized if screening starts at age 40 years. The USPSTF concluded that the decision to start biennial screening before age 50 years should be a personal one and take into account individual patient context, including an individual's values regarding specific benefits and harms. Evidence from large-scale randomized trials led the USPSTF to recommend against the teaching of breast self-examination. The USPSTF found insufficient evidence to recommend for or against performing clinical breast examination.