12:20pm Friday 15 December 2017

Breast Cancer Screening Guidelines: Talk to Your Doctor About Risk Factors

UW Health breast cancer experts say women should decide on screening frequency based on a discussion of risk factors and preferences with their doctors.

Madison, Wisconsin – The new American Cancer Society (ACS) guidelines on breast cancer screening for women bring the ACS closer to the evidence-based guidelines developed at UW Health.

We understand that different recommendations from different groups can be confusing for patients and providers. The most important thing for women to understand is that all expert groups still agree that screening for breast cancer with mammography saves lives.

The UW Health mammographic screening recommendations for women at average risk for developing breast cancer call for a single screening mammogram at age 40 to establish breast density – a recommendation based on increasing evidence that breast density may play a role in determining risk.

After that, women should decide on subsequent screening frequency based on a discussion of risk factors and preferences with their provider. Following the first screening, women in their 40s may elect to not be screened with mammography again until age 50, or may consider additional screening every one to two years. Starting at age 50, screening should occur every one to two years, with the frequency based on risk factors and discussion between patient and provider.

Our recommendations:

  1. Women at average risk for developing breast cancer should get a mammogram at age 40.
  2. After that, women should decide on screening frequency based on a discussion of risk factors with their doctors.

In contrast, the new ACS guidelines call for at minimum annual screening starting at age 45 and continuing until age 55, after which age screening should be done every other year or every year.

It is very important to recognize that the recommendations in both the UW Health and ACS guidelines are only for women who are at average risk for developing breast cancer. Women need to work with their providers to determine if they have a family history and/or prior medical history that would place them in a higher risk category for developing breast cancer.

Clinical breast exams by providers on a routine basis are no longer recommended by the ACS. This is now consistent with the UW Health guidelines that a routine clinical breast exam with each mammogram exam is not recommended.

Again, this is only for average risk women who are without concerns regarding their breast exam. If a woman is undergoing a routine physical examination and she has any concerns regarding her breast, then a clinical breast exam would be considered a part of her evaluation. Women need to be “breast aware” and notice if new changes occur so they can bring these to the attention of their providers.

UW Health will review and revise these evidence-based guidelines for breast cancer screening in the fall of 2016.


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