Imaging groups issue recommendations on screening for breast cancer

The American College of Radiology and the Society of Breast Imaging have released new recommendations on screening for breast cancer in both average- and high-risk women.

The new recommendations, which appear in the January Journal of the American College of Radiology, include the following:

• Women at average risk for breast cancer should receive annual mammography beginning at age 40.Women who carry BRCA mutations or who are untested first-degree relatives of a BRCA mutation carrier should have annual mammography and annual MRI starting by age 30 but not before age 25.Women with a 20% or more lifetime risk for breast cancer based on family history should have annual mammography and annual MRI starting by age 30 but not before age 25, or 10 years before the age of their youngest affected relative, whichever is later.Women with dense breasts as their only risk factor may benefit from the addition of ultrasound to mammography for cancer detection.

The ACR/SBI mammography recommendations conflict with the guidelines issued last November by the U.S. Preventive Services Task Force, which recommended that biennial screening start at age 50 for women at average risk and which were strongly criticized by the ACR and others after their release.

The ACR/SBI authors wrote that the new recommendations were based on peer-reviewed published data and expert consensus and were developed to address gaps in existing evidence about use of mammography, MRI, ultrasound and other imaging methods to screen for breast cancer. Unlike the USPSTF, they did not take potential harms of screening into account because they did not consider the effects of such harms to be significant, a study author told Reuters.