A Closer Look at the Latest Updates to the NCCN Guidelines on Breast Cancer Screening

For Connie Lehman, MD, PhD, the recently unveiled updates to the National Comprehensive Cancer Network guidelines for breast cancer screening and diagnosis may facilitate the use of key advances, more timely detection and prevention of advanced presentations.

In a recent interview with Diagnostic Imaging, Dr. Lehman noted a key shift with the NCCN guidelines. Previous recommendations emphasized lifetime risk models that were “heavily dependent” on family history and/or genetic mutations to determine the need for more intensive screening, according to Dr. Lehman. She said the new inclusion of an AI-powered five-year risk threshold assessment opens doors for earlier detection in women and dynamic risk modeling to facilitate preventive measures akin to the use of statins in patients with high cholesterol to reduce heart attack risk.

“This is a new field. It's a new domain, and we're just really pleased at this pivotal moment to continue the march forward (with) more precision medicine and better opportunities to prevent cancer rather than the strong work that's already been accomplished in early detection,” noted Dr. Lehman, the founder and CEO of Clairity, the manufacturer of the Clairity Breast software.

The five-year risk threshold assessment will also be available to women starting at the age of 35, according to the updated NCCN guidelines.

“I think this inclusion by the NCCN of a baseline at 35 has really acknowledged that the fastest growing group of patients being diagnosed with breast cancer are younger women before 40,” noted Dr. Lehman, a professor of radiology, who is currently on leave from Harvard Medical School. “ … We just see far too many women in their 30s — before we start screening them — routinely developing palpable breast cancers that are more advanced than we want to see in our patients with breast cancer.”

(Editor’s note: For related content, see “Mammography AI Platform for Five-Year Breast Cancer Risk Prediction Gets FDA De Novo Authorization,” “Breast Imaging in Focus: Can Partially Autonomous AI-Supported Screening Have an Impact with Mammography and DBT?” and “What New Research Reveals About Trends in Mammography Use.”)