Breast Cancer Coverage from Every Angle

ACP Issues New Guidance Statement for Breast Cancer Screening in Average-Risk Women

By: Celeste L. Dixon
Posted: Thursday, June 6, 2019

To help unmuddy the screening-recommendation waters, a new, relatively simple guideline for clinicians treating asymptomatic women at average risk for breast cancer has been developed by an expert American College of Physicians (ACP) committee and published in Annals of Internal Medicine. To create its guidance statement, the committee members consulted selected breast cancer screening guidelines published in English around the world between 2013 and 2017 and others commonly used in clinical practice.

The guidance statement recommends biennial mammography for average-risk women between the ages of 50 and 74 years. It also recommends no mammography for average-risk women 75 years of age or older (or for any woman with a life expectancy less than 10 years) and possible mammography—based on patient preference, after discussion of risks versus benefits—for average-risk women between the ages of 40 and 49 years. “The potential harms outweigh the benefits in most women aged 40 to 49 years,” wrote the committee.

The guidance statement, authored by Amir Qaseem, MD, PhD, MHA, of ACP, and colleagues, concludes by saying that clinicians should not use clinical breast examination to screen for breast cancer in average-risk women of any age. Naturally, the guideline in its entirety does not apply to women who have previously had abnormal screening results or breast cancer or to women whose genetic mutations increase their risk of breast cancer.

The organizations whose guidelines the committee consulted include the National Comprehensive Cancer Network, the American College of Radiology, the American Cancer Society, the American College of Obstetricians and Gynecologists, the Canadian Task Force on Preventive Health Care, the U.S. Preventive Services Task Force, and the World Health Organization.

Disclosure: The study authors’ disclosure information may be found at

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