Video: Stamatia Destounis, MD, Discusses the Recent ACP Guidance on Breast Cancer Screening

The recently issued breast cancer screening guidance from the American College of Physicians (ACP) present a “huge conflict” with recommendations from the American College of Radiology (ACR), the Society of Breast Imaging (SBI) and other organizations, according to Stamatia Destounis, MD, who shared her thoughts about the ACP guidance in a recent interview with Diagnostic Imaging.

For asymptomatic average risk women with BI-RADS C or D breast density, the ACP guidance recommends “supplemental” digital breast tomosynthesis (DBT) but does not recommend supplemental MRI or breast ultrasound.

“The American College of Radiology and Society of Breast Imaging recommend supplemental screening for these patients, whether it is breast MRI or another contrast study, like contrast-enhanced mammography. If the patient is unable to have one of these exams, ultrasound can be very helpful, because we're finding small, invasive cancers with ultrasound. It is very concerning that the only thing (the ACP is) recommending is tomosynthesis for this subgroup of women with dense breasts. We know that's not enough. We know we need more now,” maintained Dr. Destounis, the managing partner of Elizabeth Wende Breast Care in Rochester, N.Y.

The ACP guidance has also drawn criticism over the suggestion of biennial (vs. annual) mammography screening for asymptomatic, average risk women in their 40s after “shared decision making” with their physician about the “benefits and harms” of breast cancer screening.

“Every patient from 40 (years of age) on, if they're of average risk, (should) have a yearly mammogram — and not biannual, not after discussion, consultation and arbitration — every single woman 40 and over every year,” emphasized Dr. Destounis, the chair of the ACR’s Breast Imaging Commission.

(Editor’s note: For related content, see “Breast Radiologists Say New ACP Breast Cancer Screening Guidelines are ‘Many Steps Backward’ and ‘Dangerous,’” “Can AI Detect Breast Cancer on DBT Years Earlier than Radiologists?” and “SBI: What a New Study Reveals About Social Risk Factors and Follow-Up Imaging After Abnormal Screening Mammograms.”)