Influence
October 24, 2024

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

Sarah Wiehe, MD

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

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

Abstract

Importance: Among all US women, breast cancer is the second most common cancer and the second most common cause of cancer death. In 2023, an estimated 43 170 women died of breast cancer. Non-Hispanic White women have the highest incidence of breast cancer and non-Hispanic Black women have the highest mortality rate.

Objective: The USPSTF commissioned a systematic review to evaluate the comparative effectiveness of different mammography-based breast cancer screening strategies by age to start and stop screening, screening interval, modality, use of supplemental imaging, or personalization of screening for breast cancer on the incidence of and progression to advanced breast cancer, breast cancer morbidity, and breast cancer–specific or all-cause mortality, and collaborative modeling studies to complement the evidence from the review.

Population:  Cisgender women and all other persons assigned female at birth aged 40 years or older at average risk of breast cancer.

Evidence Assessment: The USPSTF concludes with moderate certainty that biennial screening mammography in women aged 40 to 74 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of screening mammography in women 75 years or older and the balance of benefits and harms of supplemental screening for breast cancer with breast ultrasound or magnetic resonance imaging (MRI), regardless of breast density.

Recommendation: The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 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 ultrasonography or MRI in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement)

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.

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