New Breast Cancer Guidelines From U.S. Preventive Services Task Force

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The U.S. Preventive Services Task Force (USPSTF), an independent, volunteer-based panel of national experts in primary care, prevention and evidence-based medicine, released a new set of breast cancer screening guidelines on April 30, according to a press release on their website. After a systemic evidence review of breast cancer studies, the organization now recommends that all cisgender women and those assigned female at birth at an average risk for breast cancer should be screened every other year until age 74, starting at age 40. This is also especially true if there is a family history of breast cancer (a first-degree relative). The full current recommendation statement was published in JAMA.

Approved screening methods include mammography and digital breast tomosynthesis, otherwise known as “3D mammography.” The USPSTF recommendation states that there is insufficient evidence to assess the balance of benefits and harms of supplemental screening for women over the age of 74 or for women with dense breasts with an otherwise negative mammogram. Dense breast tissue is a risk factor because it can make it harder to find cancer if it is present.

Previous USPSTF guidelines released in 2016 said screening should start at age 50 and continue every other year until age 74. Under the 2016 recommendation, women in their 40s were encouraged to decide with their providers on whether to screen for breast cancer based on their individual needs and preferences. only encouraged to speak with their doctor about screening options if they were interested.

This update was prompted by a recent increase in breast cancer cases. From 2015 to 2019 there was a yearly 2% increase in cases for women in their 40s.

In addition to the initial systemic review, the USPSTF also commissioned collaborative modeling studies from six Cancer Intervention and Surveillance Modeling Network teams.

“Collaborative modeling data estimated that compared with biennial screening from ages 50 to 74 years, biennial screening starting at age 40 years until 74 years would lead to 1.3 additional breast cancer deaths averted per 1,000 women screened over a lifetime of screening for all women,” the JAMA review reads.

The FDA is also taking steps to inform patients about breast cancer. Starting in September of this year, mammography centers must notify patients about their breast density.

Breast cancer is currently the second most common cancer and the second most deadly. Last year, an estimated 43,170 women died from it. White women have the highest rate of diagnosis at a 5-year rate of 136 cases per 100,000 women, but Black women are nearly 40% more likely to die from the disease. Black women are also the most likely to be diagnosed with a breast cancer stage beyond stage 1, despite having higher self-reported mammogram rates.

Breast cancer diagnoses peak around ages 70 to 74 with an average of 468 cases per 100,000 women. As of 2015, CDC data show that more than half of women ages 75 and older report having a mammogram within the last two years.

“More research is needed about whether and how additional screening might help women with dense breasts stay healthy and on the benefits and harms of screening in women older than 75,” the recommendation reads.

Screening recommendations come from several large national organizations with the USPSTF and the American Cancer Society being two of the most well-known.

For example, the ACS currently recommends yearly mammograms from age 45 until menopause, then every other year.