Standardizing mammogram screening in primary care: Integrating an evidence-based approach.

Abstract

Mammogram screening for surveillance and detection of breast cancer has been long recognized as a preventive health measure in primary care for women. However, a clear consensus on when to start screening individual women, based on age and risk factors, lacks guidance. Reputable organizations uphold varying breast cancer screening (BCS) guidelines for women potentiating the risk for fragmented and inconsistent practices among health care providers (HCPs). This review aims to evaluate the current literature on the possible risks, benefits, and limitations associated with BCS for women between 40 and 49 years and to discuss the need for a more individualized, evidence-based approach to BCS. A comprehensive systematic review of eight articles, along with five clinical practice guidelines published within the past 10 years that address advantages and disadvantages of receiving mammography for women in their fourth decade was completed. There is insufficient evidence to promote adherence to any single clinical practice guideline for the benefit of all patients. Further high-level research is needed, as well as the assessment of individual risk factors influencing breast cancer development and screening outcomes. There is a significant need for further education for HCPs and the development of tools that incorporate a BCS shared decision-making process. Current practice lacks the ability to easily screen individual patients with a method that identifies the appropriate age to screen and addresses the benefits, risks, and limitations of mammography.