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Breast Cancer, Screening, 2016

* Indicates an old grade definition


Recommendations: Screening for Breast Cancer

  • Breast Cancer: Screening with Mammography-- Women aged 50 to 74 years
    Grade: B
    Specific Recommendations:

    The USPSTF recommends biennial screening mammography for women aged 50 to 74 years.


    *The Department of Health and Human Services, in implementing the Affordable Care Act under the standard it sets out in revised Section 2713(a)(5) of the Public Health Service Act, utilizes the 2002 recommendation on breast cancer screening of the USPSTF.  In 2015, Congress enacted separate legislation as part of the Comprehensive Omnibus Funding law that ensured this provision remains in effect. This recommendation states: The USPSTF recommends screening mammography, with or without clinical breast examination (CBE), every 1-2 years for women aged 40 and older (B recommendation).  We provide this information here to help primary care providers understand the implications this may have on co-payments and coverage related to screening patients for breast cancer.

    Tools:

  • Breast Cancer: Screening with Mammography-- Women aged 40 to 49 years
    Grade: C
    Specific Recommendations:

    The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years.
    •   For women who are at average risk for breast cancer, most of the benefit of mammography results from biennial screening during ages 50 to 74 years. Of all of the age groups, women aged 60 to 69 years are most likely to avoid breast cancer death through mammography screening. While screening mammography in women aged 40 to 49 years may reduce the risk for breast cancer death, the number of deaths averted is smaller than that in older women and the number of false-positive results and unnecessary biopsies is larger. The balance of benefits and harms is likely to improve as women move from their early to late 40s.
    •   In addition to false-positive results and unnecessary biopsies, all women undergoing regular screening mammography are at risk for the diagnosis and treatment of noninvasive and invasive breast cancer that would otherwise not have become a threat to their health, or even apparent, during their lifetime (known as “overdiagnosis”). Beginning mammography screening at a younger age and screening more frequently may increase the risk for overdiagnosis and subsequent overtreatment.
    •   Women with a parent, sibling, or child with breast cancer are at higher risk for breast cancer and thus may benefit more than average-risk women from beginning screening in their 40s.

    Go to the Clinical Considerations section for information on implementation of the C recommendation.




    *The Department of Health and Human Services, in implementing the Affordable Care Act under the standard it sets out in revised Section 2713(a)(5) of the Public Health Service Act, utilizes the 2002 recommendation on breast cancer screening of the USPSTF.  In 2015, Congress enacted separate legislation as part of the Comprehensive Omnibus Funding law that ensured this provision remains in effect. This recommendation states: The USPSTF recommends screening mammography, with or without clinical breast examination (CBE), every 1-2 years for women aged 40 and older (B recommendation).  We provide this information here to help primary care providers understand the implications this may have on co-payments and coverage related to screening patients for breast cancer.

    Tools:

  • Breast Cancer: Screening with Mammography-- Women aged 75 years or older
    Grade: I
    Specific Recommendations:

    The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older.

    Tools:

  • Breast Cancer: Screeningmethod with digital breast tomosynthesis(DBT)-- All women
    Grade: I
    Specific Recommendations:

    The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer.

    Tools:

  • Breast Cancer: Screening -- Women with dense breasts
    Grade: I
    Specific Recommendations:

    The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging, DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram.

    Tools:

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