Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement

Published in the journal JAMA. Here is a link to the article.

Regenstrief Institute authors: Sarah Wiehe M.D., MPH

Breast cancer is the second most common cancer and cause of cancer-related death among U.S. women, with an estimated 43,170 deaths in 2023. While non-Hispanic White women exhibit the highest incidence, non-Hispanic Black women face the highest mortality. To guide clinical practice, the U.S. Preventive Services Task Force (USPSTF) conducted a systematic review and collaborative modeling studies assessing mammography screening strategies. The review focused on various screening approaches—based on age, frequency, modality, and supplemental imaging—and their impact on the incidence of advanced breast cancer, morbidity, and mortality.

The USPSTF determined with moderate certainty that biennial mammography screening for average-risk cisgender women and others assigned female at birth, aged 40 to 74, offers a moderate net benefit. However, the Task Force found insufficient evidence to assess the benefit-harm balance of screening in women aged 75 and older, as well as the use of supplemental imaging (e.g., ultrasound or MRI) for those with dense breasts.

Based on these findings, the USPSTF issued a B recommendation for biennial screening mammography in women aged 40 to 74. Conversely, I statements (indicating insufficient evidence) were issued regarding screening for women 75 and older and for supplemental imaging in those with dense breasts. These recommendations aim to inform preventive care practices and optimize breast cancer outcomes through early detection while acknowledging areas requiring further research.

Authors

US Preventive Services Task Force; Wanda K Nicholson¹, Michael Silverstein², John B Wong³, Michael J Barry⁴, David Chelmow⁵, Tumaini Rucker Coker⁶, Esa M Davis⁷, Carlos Roberto Jaén⁸, Marie Krousel-Wood⁹, Sei Lee¹⁰, Li Li¹¹, Carol M Mangione¹², Goutham Rao¹³, John M Ruiz¹⁴, James J Stevermer¹⁵, Joel Tsevat⁸, Sandra Millon Underwood¹⁶, Sarah Wiehe¹⁷

Author Affiliations

¹George Washington University, Washington, DC.

²Brown University, Providence, Rhode Island.

³Tufts University School of Medicine, Boston, Massachusetts.

⁴Harvard Medical School, Boston, Massachusetts.

⁵Virginia Commonwealth University, Richmond.

⁶University of Washington, Seattle.

⁷University of Maryland School of Medicine, Baltimore.

⁸The University of Texas Health Science Center, San Antonio.

⁹Tulane University, New Orleans, Louisiana.

¹⁰University of California, San Francisco.

¹¹University of Virginia, Charlottesville.

¹²University of California, Los Angeles.

¹³Case Western Reserve University, Cleveland, Ohio.

¹⁴University of Arizona, Tucson.

¹⁵University of Missouri, Columbia.

¹⁶University of Wisconsin, Milwaukee.

¹⁷Indiana University, Bloomington.