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Breast Cancer Screening Guidelines

AMERICAN CANCER SOCIETY
SCREENING GUIDELINES

For women at average risk
These guidelines are for women at average risk for breast cancer. Women with a personal history of breast cancer, a family history of breast cancer, a genetic mutation known to increase risk of breast cancer (such as BRCA), and women who had radiation therapy to the chest before the age of 30 are at higher risk for breast cancer, not average-risk. (See below for guidelines for women at higher than average risk.)

Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so. The risks of screening as well as the potential benefits should be considered.

Women age 45 to 54 should get mammograms every year.

Women age 55 and older should switch to mammograms every 2 years, or have the choice to continue yearly screening.

Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.

All women should be familiar with the known benefits, limitations, and potential harms associated with breast cancer screening. They should also be familiar with how their breasts normally look and feel and report any changes to a health care provider right away.

Mammograms
Regular mammograms can often help find breast cancer at an early stage, when treatment is most likely to be successful. A mammogram can find breast changes that could be cancer years before physical symptoms develop. Results from many decades of research clearly show that women who have regular mammograms are more likely to have breast cancer found early, less likely to need aggressive treatment (like surgery to remove the entire breast [mastectomy] and chemotherapy), and more likely to be cured.

Mammograms are not perfect. They miss some cancers. And sometimes more tests will be needed to find out if something found on a mammogram is or is not cancer. There’s also a small possibility of being diagnosed with a cancer that never would have caused any problems had it not been found during screening. It’s important that women getting mammograms know what to expect and understand the benefits and limitations of screening.

Clinical breast exam and breast self-exam
Research does not show a clear benefit of physical breast exams done by either a health professional or by yourself for breast cancer screening. Due to this lack of evidence, regular clinical breast exam and breast self-exam are not recommended. Still, all women should be familiar with how their breasts normally look and feel and report any changes to a health care provider right away.

For women at higher than average risk
Women who are at high risk for breast cancer based on certain factors should get an MRI and a mammogram every year. This includes women who:

  • Have a lifetime risk of breast cancer of about 20% to 25% or greater, according to risk assessment tools that are based mainly on family history (such as the Claus model – see below)
  • Have a known BRCA1 or BRCA2 gene mutation
  • Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
  • Had radiation therapy to the chest when they were between the ages of 10 and 30 years
  • Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have first-degree relatives with one of these syndromes

UNITED STATES PREVENTIVE SERVICES TASK FORCE
SCREENING GUIDELINES

Population Recommendation
Women, Age 50-74 Years The USPSTF recommends a mammography every two years for women 50-74 years.
Women, Before the Age of 50 Years The USPSTF recommends against routinely providing mammography. There may be considerations that support providing the service in an individual patient.
Women, 75 Years and Older The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of screening mammography in women 75 years and older.
All Women The USPSTF recommends against teaching breast self-examination (BSE). There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.
Women, 40 Years and Older The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening.
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