mammography

Breast Density

Screening for Breast Cancer

Information for patients about dense breast tissue. James W. Mold, MD, MPH

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This JAMA Internal Medicine Patient Page describes dense breasts and whether they might lead to higher risk for breast cancer.

Author/s:

Hannah S Milch, Joann G Elmore

Screening for Breast Cancer

Alex Haga — Tue, 07 May 2024 21:10:39 +0000

Date Added:

May 7, 2024

Journal/Publication:

JAMA Patient Page

Publisher:

JAMA

Publication Date:

April 30, 2024

URL:

Type:

Patient Education Materials

Format:

Article

DOI (1):

10.1001/jama.2024.5535

Keywords

Early Detection of Cancer

PMID (1):

38687488

MeSH

Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement

risk assessment

Information for patients about the new screening recommendations from the USPSTF. James W. Mold, MD, MPH

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We all want better ways to find breast cancer early and save lives from this disease. Breast cancer screening can detect cancer early, when it’s most treatable. This guide is meant to help you and your health care professional understand the benefits and risks of breast cancer screening, including what age to start screening and how often people should be screened. This guide is not for women who have a BRCA gene variant, a history of chest radiation, or a personal history of breast cancer. These women should talk to their health care professional about how best to stay healthy.

Author/s:

US Preventive Services Task Force

Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement

Alex Haga — Tue, 07 May 2024 21:01:58 +0000

Date Added:

May 7, 2024

Journal/Publication:

JAMA

Publisher:

JAMA

Publication Date:

April 30, 2024

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2024.5534

Keywords

breast cancer

cancer screening

Early Detection of Cancer

PMID (1):

38687503

MeSH

Magnetic Resonance Imaging

The USPSTF now recommends beginning biennial breast cancer screening at 40 rather than 50 in most women. James W. Mold, MD, MPH

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Importance: Among all US women, breast cancer is the second most common cancer and the second most common cause of cancer death. In 2023, an estimated 43 170 women died of breast cancer. Non-Hispanic White women have the highest incidence of breast cancer and non-Hispanic Black women have the highest mortality rate.

Objective: The USPSTF commissioned a systematic review to evaluate the comparative effectiveness of different mammography-based breast cancer screening strategies by age to start and stop screening, screening interval, modality, use of supplemental imaging, or personalization of screening for breast cancer on the incidence of and progression to advanced breast cancer, breast cancer morbidity, and breast cancer-specific or all-cause mortality, and collaborative modeling studies to complement the evidence from the review.

Population: Cisgender women and all other persons assigned female at birth aged 40 years or older at average risk of breast cancer.

Evidence assessment: The USPSTF concludes with moderate certainty that biennial screening mammography in women aged 40 to 74 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of screening mammography in women 75 years or older and the balance of benefits and harms of supplemental screening for breast cancer with breast ultrasound or magnetic resonance imaging (MRI), regardless of breast density.

Recommendation: The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of supplemental screening for breast cancer using breast ultrasonography or MRI in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement).

Author/s:

US Preventive Services Task Force

Continuation of Annual Screening Mammography and Breast Cancer Mortality in Women Older Than 70 Years

Brian Desmarais — Tue, 25 Feb 2020 15:27:32 +0000

Date Added:

February 25, 2020

Journal/Publication:

Annals of Internal Medicine

Publication Date:

February 25, 2020

URL:

Continuation of Annual Screening Mammography and Breast Cancer Mortality in Women Older Than 70 Years

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.7326/M18-1199

Keywords

MeSH

Discussions of Dense Breasts, Breast Cancer Risk, and Screening Choices in 2019

Rare Diseases

Records

Evidence from a large cohort study that annual mammography beyond age 70 does not reduce breast cancer mortality. James W. Mold, MD, MPH

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BACKGROUND:

Randomized trials have shown that initiating breast cancer screening between ages 50 and 69 years and continuing it for 10 years decreases breast cancer mortality. However, no trials have studied whether or when women can safely stop screening mammography. An estimated 52% of women aged 75 years or older undergo screening mammography in the United States.

OBJECTIVE:

To estimate the effect of breast cancer screening on breast cancer mortality in Medicare beneficiaries aged 70 to 84 years.

DESIGN:

Large-scale, population-based, observational study of 2 screening strategies: continuing annual mammography, and stopping screening.

SETTING:

U.S. Medicare program, 2000 to 2008.

PARTICIPANTS:

1 058 013 beneficiaries aged 70 to 84 years who had a life expectancy of at least 10 years, had no previous breast cancer diagnosis, and underwent screening mammography.

MEASUREMENTS:

Eight-year breast cancer mortality, incidence, and treatments, plus the positive predictive value of screening mammography by age group.

RESULTS:

In women aged 70 to 74 years, the estimated difference in 8-year risk for breast cancer death between continuing and stopping screening was -1.0 (95% CI, -2.3 to 0.1) death per 1000 women (hazard ratio, 0.78 [CI, 0.63 to 0.95]) (a negative risk difference favors continuing). In those aged 75 to 84 years, the corresponding risk difference was 0.07 (CI, -0.93 to 1.3) death per 1000 women (hazard ratio, 1.00 [CI, 0.83 to 1.19]).

LIMITATIONS:

The available Medicare data permit only 8 years of follow-up after screening. As with any study using observational data, the estimates could be affected by residual confounding.

CONCLUSION:

Continuing annual breast cancer screening past age 75 years did not result in substantial reductions in 8-year breast cancer mortality compared with stopping screening.

PRIMARY FUNDING SOURCE:

National Institutes of Health.

Author/s:

García-Albéniz, X., Hernán, M.A., Logan, R.W., Price, M., Armstrong, K., Hsu, J.

Discussions of Dense Breasts, Breast Cancer Risk, and Screening Choices in 2019

Brian Desmarais — Wed, 05 Jun 2019 00:21:43 +0000

Date Added:

June 4, 2019

Journal/Publication:

JAMA

Publisher:

JAMA Network

Publication Date:

May 31, 2019

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2019.6247

Keywords

mammography screening

Reproducibility of Results

MeSH

Breast Density

risk factors

Breast

Treatment of Nonmetastatic Breast Cancer

Radiologists

Adipose Tissue

This is a concise review of what we know now about breast density and cancer risk and how to help patients interpret mammographic reports. James W. Mold, MD, MPH

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Breast density, a radiologic term that describes the proportion of parenchymal relative to fatty tissue in mammograms, is a strong and prevalent risk factor. With increasing breast density, the risk of having a breast cancer masked or hidden on mammography increases, as does future breast cancer risk.1 Almost 50% of US women aged 40 to 74 years have dense breasts (an estimated 27.6 million women). The widespread incorporation of breast density information into screening mammography reports in 36 US states and suggestion to consider supplemental imaging has resulted in women raising questions about breast density and supplemental imaging with their clinicians.2 Thus, clinicians need to be knowledgeable of the clinical significance of breast density and how it may be useful when combined with breast cancer risk to inform screening discussions.

Author/s:

Kerlikowske, Karla", C.M., Miglioretti, D.L.

Treatment of Nonmetastatic Breast Cancer

Tracy Ashby — Mon, 15 Apr 2019 05:00:00 +0000

Date Added:

April 15, 2019

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

April 12, 2019

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2019.3927

Keywords

breast cancer

mammography screening

early detection

PMID (1):

30977769

MeSH

Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians

A concise algorithmic summary of the current approach to treatment of invasive stage I to III breast cancer. James W. Mold, MD, MPH

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The treatment of breast cancer has evolved largely based on refinements in understanding of the biology of the disease and the variable risk for mortality among separate disease subtypes.1 Further, due to widespread use of screening mammography, there is a reduction in average breast tumor size at diagnosis. Breast cancer primarily affects women but also affects a smaller number of men. Because many clinicians provide medical care to patients with breast cancer, familiarity with contemporary treatments is important. In this JAMA Insights article, current practices and emerging trends in breast oncology are highlighted, including aspects of precision oncology and the recent deescalation of certain treatments to minimize long-term toxicities.

Author/s:

Ruddy, Kathryn J., Ganz, Patricia A.

Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians

Tracy Ashby — Tue, 09 Apr 2019 05:00:00 +0000

Date Added:

April 9, 2019

Journal/Publication:

Annals of Internal Medicine

Publisher:

American College of Physicians

Publication Date:

April 9, 2019

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.7326/M18-2147

Keywords

breast cancer

average-risk women

mammography screening

PMID (1):

30959525

MeSH