Practice Bulletin Number 179: Breast Cancer Risk Assessment and Screening in Average-Risk Women.

  title={Practice Bulletin Number 179: Breast Cancer Risk Assessment and Screening in Average-Risk Women.},
  journal={Obstetrics and gynecology},
  volume={130 1},
  • Published 2017
  • Medicine
  • Obstetrics and gynecology
Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about… 

Benefits and Risks of Mammography Screening in Women Ages 40 to 49 Years

The primary benefits of screening for women in their 40s are a reduction in breast cancer mortality, years of life lost to breast cancer, and morbidity of breast cancer treatment by detecting cancers at an earlier stage and this information should help providers in their shared decision-making discussions with patients.

Breast Cancer Screening for Women at Average Risk

There are multiple organizations with recommendations for breast cancer screening in women at average risk but differ in the age at which to initiate mammograms, screening interval, and the age in which to stop screening.

Current controversies in breast cancer screening.

Debates ensue over the appropriate age at which to begin screening for breast cancer, how often screening should occur, and when to stop.

Breast Cancer Screening: An Overview of Risk-specific Screening and Risk Assessment.

  • D. Scott
  • Medicine, Political Science
    Clinical obstetrics and gynecology
  • 2022
This work states that annual mammography starting at age 40 is associated with the greatest reduction in breast cancer mortality and greatest number of life-years saved.

Breast Cancer Screening in Older Women: The Importance of Shared Decision Making

Current recommendations for breast cancer screening in women over the age of 74 are reviewed and clear guidelines for primary care clinicians to follow are presented that incorporate shared decision- making techniques, tools for estimating the risks and benefits of screening mammography, and strategies for integrating a patient's life expectancy and comorbidities into the decision-making process.

The Landmark Series—Addressing Disparities in Breast Cancer Screening: New Recommendations for Black Women

This review examined the epidemiologic and socioeconomic factors that are associated with breast cancer among black women and assess the implications of these factors for screening in this population.

Breast Cancer Screening Modalities

The role of clinical examination and biomarkers, a welcome addition to the imaging methods used for breast cancer screening, will be dealt with in this chapter.

Utility of Genetic Testing in Addition to Mammography for Determining Risk of Breast Cancer Depends on Patient Age

  • S. FeldJun Fan E. Burnside
  • Medicine
    AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science
  • 2018
Genetic testing supplements mammography in younger women while mammography appears sufficient in older women for breast cancer risk prediction, and logistic regression with group lasso develops predictive models.

Breast Cancer Screening During Lactation: Ensuring Optimal Surveillance for Breastfeeding Women.

Routine breast cancer screening for breastfeeding women should be considered, given the increased risk of biologically aggressive breast cancers in postpartum women, and these risks may be outweighed by the benefits of routine breast cancer screened women.



Screening mammography in older women: a review.

Providing information about life expectancy along with potential benefits and harms of screening may help older women's decision-making about screening mammography, and should emphasize increased potential harms from screening and highlight health promotion measures likely to be beneficial over the short term.

Population screening and intensity of screening are associated with reduced breast cancer mortality: evidence of efficacy of mammography screening in Australia

Participation in screening was associated with a breast-cancer mortality reduction of between 30 and 41%, depending on assumptions about screening self-selection bias, and a downward mortality risk by recency of last screen prior to cancer diagnosis, and frequency of recent screening, is consistent with a screening effect.

Assessing women at high risk of breast cancer: a review of risk assessment models.

This review aims to distill the diverse literature and provide practicing clinicians with an overview of the available risk assessment methods and allow clinicians to more accurately determine which women are most likely to develop breast cancer.

Method of detection of breast cancer in low-income women.

Pat age, ethnicity, and regular source of care were associated with method of breast cancer detection in a low-income underserved population, and the rate of self-detection in this population correlates with the literature, but efforts to increase mammography screening need to be improved.

Self-detection remains a key method of breast cancer detection for U.S. women.

Patient characteristics and time trends for various methods of breast cancer detection in the United States are described and a large percentage of breast cancers are detected by the patients themselves.

Outcomes of screening mammography by frequency, breast density, and postmenopausal hormone therapy.

Women aged 50 to 74 years, even those with high breast density or HT use, who undergo biennial screening mammography have similar risk of advanced-stage disease and lower cumulative risk of false-positive results than those who undergo annual mammography.

Service screening with mammography in Northern Sweden: effects on breast cancer mortality – an update

This study confirms previous findings in the earlier follow-up and indicates a long-term reduction of breast cancer mortality by 26–30%.

Potential Overuse of Screening Mammography and Its Association With Access to Primary Care

Substantial proportions of women with limited life expectancy receive screening mammography, and a cautionary note that greater access to primary care and mammographic resources is also associated with higher overuse.

Benefits and Harms of Breast Cancer Screening: A Systematic Review.

Evidence for the relationship between screening and life expectancy and quality-adjusted life expectancy was low in quality and uncertainty remains about the magnitude of associated mortality reduction in the entire US population, among women 40 to 49 years, and with annual screening compared with biennial screening.