Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News
[elfsight_social_share_buttons id=”1″]
The U.S. Preventive Services Task Force (USPSTF) is updating draft recommendations on breast cancer screening.
The new USPSTF guidance recommends mammograms for breast cancer screening beginning at age 40 for American women and should continue every other year until age 74. This change is expected to decrease the number of breast cancer deaths by 19% when compared with the previous recommendations. These guidelines are intended for women of average risk for breast cancer.
The new guidance shifts away from the controversial recommendation in 2009 and 2016 that most women should wait until age 50 to begin having mammograms and that women could be screened every other year instead of annually. Experts agree that early detection of breast cancer gives women the best chance of survival.
“New and more inclusive science about breast cancer in people younger than 50 has enabled us to expand our prior recommendation and encourage all women to get screened every other year starting at age 40,” said Dr. Carol Mangione, chief of internal medicine at UCLA and the chair of the group that wrote the task force’s proposed recommendation. The new guidelines “will help save lives and prevent more women from dying due to breast cancer,” she added.
THOSE AT HIGHER RISK
According to the draft, black women are 40% more likely to die from breast cancer than white women and tend to develop more aggressive types of breast cancer. It is important that screening starts at age 40. However, it is critical that “healthcare professionals involve patients in a conversation on how best to support them to ensure equitable follow-up after screening and timely and effective treatment of breast cancer.”
Women with dense breasts are also at increased risk for breast cancer, making malignancy more difficult to detect on mammogram images. Almost half of all women have dense breasts, but there is little research on how or if additional screenings may detect cancer. The panel urges that more research is important to identify if breast ultrasound or MRI would ensure earlier detection in women with dense breasts.
The panel of health experts noted that shifting from the least-intensive to the most-intensive screening schedule tripled the number of mammograms an average woman received, the number of false positive readings increased, and the rate of overdiagnosis increased from 8% of cases to 17%.
For women aged 75 years and older, the current evidence is insufficient to assess the risks and benefits associated with continuing screenings.
While this new recommendation is “a step in the right direction,” the American College of Radiology(ACR) and Society of Breast Imaging (SBI) said in a statement that “annual mammography screening for all average-risk women ages 40 and older” is needed, adding that “the most lives are saved with this annual approach.
The organizations cite evidence that shows annual screenings are crucial for black and other minority women, Jewish women, and others who develop and die from breast cancer prior to age 40 and more often than white women. They also recommend that all women have a risk assessment done by age 25 as well as continued breast cancer screening in women aged 75 and older based on past medical history and comorbidities.
Breast cancer is currently the most common cancer worldwide, accounting for 12.5% of all new cancer cases across the globe each year and about 13% of American women will develop breast cancer at some point in their lifetime. Breast cancer is one of the leading causes of cancer-related deaths in women in the U.S.
The USPSTF draft evidence review and recommendation statement are posted for public comment and comments can be submitted from May 9 through June 5, 2023.