ACP Updates Guidance on Mammography Screening
In a new guidance statement published in the Annals of Internal Medicine, the American College of Physicians (ACP) now suggests women with average risk of developing breast cancer receive mammography screenings every other year between the age 50 and 74 years. In addition, they argue that clinicians should not rely on clinical breast examination for cancer screening purposes.
The ACP reviewed various mammography guidelines from across the globe, including those from the American College of Radiology and the Canadian Task Force on Preventive Health Care, to come up with a consistent set of guidelines concerning women without increased risk of disease.
For women who do not have a family history of breast cancer or a genetic mutation known to increase their risk of developing breast cancer, the ACP now recommends clinicians discuss the pros and cons of breast cancer screening with women younger than 50 years of age, in order to help them better understand a patient’s preferences as well as to highlight why mammography may offer more potential harms than good to this particular age group. Women between 50-74 years should be offered screenings biennially—and women older than 75, with a life expectancy of 10 years or less, should forego mammography screenings altogether, according to the new guidelines.
The guidance statement notes that biennial mammography screening results in no significant difference in breast cancer mortality compared to annual screening—and reduces the risk of abnormal, but not cancerous results, that can result in unnecessary surgical procedures as well as potential psychological harms.
With this new guidance, based on converging research evidence, ACP hopes to reduce breast cancer overdiagnosis and improve clinical benefits to women at average risk for breast cancer across the country. In a related editorial, physicians discussed why these updated mammography guidelines are so important—and how they can better serve patients in the future.