Screening for Breast Cancer
- Study type
- Clinical guideline
- Study name
- USPSTF 2024
- Design
- Clinical guideline recommendation statement based on a systematic review and collaborative modelling studies
- Source
- JAMA · 2024
In plain words
This guideline recommends that women at average risk of breast cancer have a mammogram every two years from age 40 to 74. For women aged 75 or older, there is not yet enough evidence to say whether screening does more good or more harm. Also, for women who have dense breasts and a normal mammogram, there is not enough evidence about the benefit of an extra ultrasound or MRI. Make the final decision with your doctor, based on your own situation.
Key points
Key guideline recommendations
- B
The USPSTF recommends biennial screening mammography for women aged 40 to 74 years.
- I statement
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older.
- I statement
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of supplemental screening for breast cancer using breast ultrasound or MRI in women identified to have dense breasts on an otherwise negative screening mammogram.
Study population
Cisgender women and all other persons assigned female at birth, aged 40 years or older, at average risk of breast cancer.
Endpoints
The USPSTF-commissioned systematic review assessed the comparative effectiveness of different mammography-based breast cancer screening strategies by age to start and stop screening, screening interval, imaging modality, use of supplemental imaging or personalisation of screening. Outcomes examined included incidence of and progression to advanced breast cancer, breast cancer morbidity, and breast cancer-specific or all-cause mortality. Collaborative modelling studies were also performed to complement the review evidence.
Safety and side effects
The abstract gives no numerical data on harms of screening. According to the abstract, the evidence is insufficient to determine the balance of benefits and harms in women aged 75 years or older and for supplemental screening with ultrasound or MRI. Details of harms are in the full text.
Clinical significance and place in guidelines
Based on the abstract, this USPSTF statement recommends biennial screening mammography for average-risk women aged 40 to 74 years (grade B). For women aged 75 years or older and for supplemental screening with ultrasound or MRI in women with dense breasts, there is no definitive recommendation (I statement). These recommendations were developed for the US population. Their alignment with national and local guidelines and the current status of other guidelines should be checked separately.
Limitations
According to the abstract, the evidence is insufficient for women aged 75 years or older and for supplemental screening with ultrasound or MRI in women with dense breasts. These recommendations apply only to people at average risk of breast cancer. Errata have been published for this article and should be checked in the full text.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.