York County Medicine Fall 2021 - 14

YORKCOMEDSOC.ORG
FEATURE:
BREAST CANCER SCREENING
Women
aged 40 to 49 years
with average risk
U.S. Preventive
Services Task
Force1,2
The decision to start screening with 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
screening once every two years between the ages of 40
and 49 years.
American Cancer Society3
Women aged 40 to 44 years should have the choice
to start breast cancer screening once a year with
mammography if they wish to do so. The risks of
screening as well as the potential benefits should be
considered. Women aged 45 to 49 years should be
screened with mammography annually.
Women
aged 50 to 74 years
with average risk
Screening with mammography once every two years is
recommended.
The evidence is insufficient to assess the additional
benefits and harms of clinical breast examination.
Women aged 50 to 54 years should be screened with
mammography annually. For women aged 55 years and
older, screening with mammography is recommended
once every two years or once a year. Women aged 55
years and older should transition to biennial screening
or have the opportunity to continue screening annually.
Among average risk women, clinical breast examination
to screen for breast cancer is not recommended.
American College
of Obstetricians and
Gynecologists4,5,6
After counseling and if an individual desires screening,
mammography may be offered once a year or once
every two years and clinical breast exams may be offered
once a year. Decisions between screening with
mammography once a year or once every two years
should be made through shared decision-making after
appropriate counseling.
Screening with mammography is recommended once
a year or once every two years. Decisions between
screening with mammography once a year or once every
two years should be made through shared decisionmaking
after appropriate counseling.
Clinical breast exams may be offered annually.
Clinical breast exams should be offered in the context
of a shared, informed decision-making approach that
recognizes the uncertainty of additional benefits and
harms of clinical breast examination beyond screening
mammography.
International Agency for
Research on Cancer7
There is limited evidence that screening with
mammography reduces breast cancer mortality in
women 40-49 years of age.
There is sufficient evidence that screening with
mammography reduces breast-cancer mortality to an
extent that its benefits substantially outweigh the risk of
radiation-induced cancer from mammography.
There is inadequate evidence that clinical breast
examination reduces breast cancer mortality. There
is sufficient evidence that clinical breast examination
shifts the stage distribution of tumors detected toward
a lower stage.
American College of
Radiology8,9
Screening with mammography is recommended once
a year.
Screening with mammography is recommended once
a year.
American College of
Physicians10
Clinicians should discuss whether to screen for breast
cancer with mammography before age 50 years.
Discussion should include the potential benefits and
harms and a woman's preferences. The potential harms
outweigh the benefits in most women aged
40 to 49 years.
American
Academy of
Family
Physicians11
14 York County Medicine | FALL 2021
The decision to start screening with
mammography
should be an individual one.
Women who place a higher value on the potential
benefit than the potential harms may choose
to begin screening.
Clinicians should offer screening with mammography
once every two years. In average-risk women of all ages,
clinicians should not use clinical breast examination to
screen for breast cancer.
Screening with mammography is recommended once
every two years.
Current evidence is insufficient to assess the benefits
and harms of clinical breast exams.
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York County Medicine Fall 2021

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