The U.S. Preventive Services Task Force ( Task Force ) has posted a draft recommendation statement and draft evidence documents on screening for breast cancer. The Task Force, an independent, volunteer Panel of Experts in preventive care and evidence-based medicine, reviewed the scientific data about the benefits and harms associated with breast cancer screening, and has posted a draft recommendation statement based on that evidence. The draft recommendation statement is made up of several recommendations, addressing different age groups and screening methods.
Based on the evidence, the Task Force found that the benefit of mammography screening increases with age, with women ages 50 to 74 benefiting most. Women get the best balance of benefits to harms when screening is done every two years.
This is a B recommendation.
For women in their 40s, the Task Force found that mammography screening every two years can also be effective and recommends that the decision to start screening should be an individual one, recognizing the potential benefits as well as the potential harms.
This is a C recommendation.
The science shows that some women in their 40s will benefit from mammography, most will not, while others will be harmed.
Of the potential harms, the most serious is unneeded diagnosis and treatment for a type of breast cancer that would not have become a threat to a woman’s health during her lifetime.
The most common harm is a false-positive test result, which often leads to additional tests and procedures. While some women do not mind the anxiety that accompanies a false-positive mammogram, other women consider this a harm.
Among women in their 40s, women who have a mother, sister, or daughter with breast cancer may benefit more than average-risk women by beginning screening before age 50.
The Task Force rated this recommendation as a C, noting that mammography for women in their 40s is effective in reducing deaths from breast cancer, but that the benefits are less than for older women and the harms potentially greater.
The Task Force has developed several additional recommendations as part of this draft recommendation statement.
• For women age 75 and older, the Task Force determined that the current evidence is insufficient to make a recommendation for or against mammography screening. This is an I statement, and the Task Force encourages more research on screening in this age group.
• While 3-D mammography is a promising new technology for the detection of breast cancer, the Task Force did not find enough evidence to determine whether it will result in better overall health outcomes for women. Therefore, the Task Force cannot make a recommendation for or against 3-D mammography, and is issuing an I statement, encouraging additional research in this area.
• Certain factors increase a woman’s risk for developing breast cancer. Women who have dense breasts are at an increased risk, and high breast density also reduces the ability of mammography to find and accurately identify breast cancer. However, the evidence on how additional screening beyond mammography may or may not help women with dense breasts is unclear. The Task Force cannot make a recommendation for or against such additional screening, and is also encouraging additional research in this area. This is an I statement.
Mammography is an important tool in reducing the number of breast cancer deaths. Based on the evidence, the Task Force found that screening is most beneficial for women ages 50 to 74.
The evidence shows that screening women age 40 to 49 is beneficial as well, but fewer women will avoid a breast cancer death by screening at this age. The number of women who experience a false positive result and unnecessary testing is actually higher. Women who place a higher value on the potential benefit than the potential harms may choose to begin screening between the ages of 40 and 49. ( Xagena )
Source: U.S. Preventive Services Task Force, 2015