By Romane Joseph, MD
Breast cancer screening: A number of expert groups have developed recommendations related to age to initiate screening.
- Age under 40 — We suggest not screening average-risk women who are under 40 years of age. Among women younger than 40, the incidence of breast cancer is low, there are no randomized trials of breast cancer screening, and performance characteristics of mammography are poor.
- Age 40 to 49 — Most expert groups encourage shared decision-making for women in their 40s because of trade-offs between benefits and harms. we engage in shared decision-making to encourage women to individualize the decision based on the benefits and harms of screening and their personal values and preferences. For women who decide to initiate screening in their 40s, we typically suggest screening mammography every two years.
- Age 50 to 74 — We suggest breast cancer screening
with mammography for average-risk women aged 50 to 74 years. We typically
screen every two years, unless the prior screening identified a finding for
which more frequent breast imaging was advised.
- All expert groups recommend routine screening with mammography for women at average risk who are age 50 or older, and most agree to continue screening through age 74 years (at least). However, recommendations on the frequency of mammography screening for this age group vary
- Age 75 and older — We suggest that women over the age of 74 be offered screening only if their life expectancy is at least 10 years. For women in this age group who elect to be screened, we typically screen with mammography every two years.
- Mammography as preferred screening
modality — Among a
variety of imaging modalities developed for breast cancer screening,
mammography is the best-studied and the only imaging technique that has been
shown to decrease mortality
- Mammography is available as digital and as film mammography. The choice between them generally depends on availability
- For women with dense breasts, digital mammography, if available, is preferred because of higher sensitivity; the sensitivity of mammography is inversely correlated with breast density, especially with older film
- Other imaging modalities — For average-risk women, there is a lack of medical evidence to routinely recommend other radiologic modalities or supplemental radiologic screening with ultrasound, MRI, or newer imaging technologies
Romane Joseph, MD | Joseph Surgery
Dade: 9415 NE 6th Ave, Miami Shores, FL 33138 | Broward: 4900 West Oakland Park, Blvd., #107, FT. Luaderdale, FL, 33313
Phone: (786) 401-6455 | Website: www.josephsurgerymiami.com