Updated recommendations for breast cancer screening

Abstract

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