ACR and SBI Comment on Updated USPSTF Breast Cancer Screening Recommendations

By: Victoria Kuhr, BA
Posted: Monday, June 26, 2023

Although the American College of Radiology (ACR) and the Society of Breast Imaging (SBI) consider the updated U.S. Preventive Services Task Force (USPSTF) recommendations for breast cancer screening a “step in the right direction,” they encourage the USPSTF to go further to recommend annual mammography screening for all average-risk women aged 40 and older. The ACR and SBI also recommend that all women, regardless of race or ethnicity, have a breast cancer risk assessment by age 25. Furthermore, the ACR recommends that women at higher-than-average risk of breast cancer undergo annual digital mammography beginning between the ages of 25 and 40. The corresponding author of these updated ACR recommendations for women at higher-than-average risk is Debra L. Monticcciolo, MD, FACR, of Massachusetts General Hospital, Harvard Medical School, Boston.

Highlights from the ACR recommendations for breast cancer screening for women at higher-than-average risk follow here.

• Women with genetic mutations, their untested first-degree relatives, and those with a calculated lifetime risk of 20% or more are recommended to have an annual digital mammogram, with or without digital breast tomosynthesis, starting at age 30 and annual MRI starting at between age 25 and 30.
• Women carrying a mutated gene may delay mammographic screening until age 40 if annual breast MRIs are performed as recommended. Additionally, women exposed to a cumulative chest radiation therapy dose of more than 10 Gy by age 30 should have annual mammography starting at age 25 or 8 years after radiation therapy and annual breast MRI beginning at between the ages of 25 and 30.
• Women diagnosed with breast cancer prior to age 50, have a family history of breast cancer, have dense breasts, or have atypia or lobular carcinoma in situ are encouraged to undergo a supplemental surveillance MRI. However, women who qualify for but cannot undergo a breast MRI may have a contrast-enhanced mammography or ultrasound.

Disclosure: Dr. Monticciolo reported no conflicts of interest. For full disclosures of all authors of the ACR recommendations, visit www.jacr.org.

American College of Radiology

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