OB/GYN Group Revises Breast Screening Recommendations for Average-Risk Women

News in Context |
July 6, 2017

OB/GYN Group Revises Breast Screening Recommendations for Average-Risk Women

  1. Andrew M. Kaunitz, MD

ACOG takes into account personal values about benefits and risks of screening.

  1. Andrew M. Kaunitz, MD

The American College of Obstetricians and Gynecologists (ACOG) has updated its guidance on breast cancer screening in average-risk women to emphasize shared decision making between the patient and provider.

Previously, the group recommended that average-risk women undergo annual screening mammography beginning at age 40. Now, the group advises the following:

  • Women should be offered screening mammography beginning at age 40. If women don't start screening in their 40s, they should do so at age 50. The decision on when to begin screening should follow a discussion of the potential benefits and harms of screening.

  • Screening should occur every 1 or 2 years, depending on the patient's preference. Screening every 2 years, especially for women aged 55 and older, is “reasonable.”

  • Women should be screened until at least age 75. After this, the decision whether to stop screening should follow a discussion of the woman's current health and life expectancy.

  • Clinical breast exam can be offered to women aged 25–39 every 1 to 3 years. For women aged 40 and older, the exam can be offered annually.

Comment

These updated breast cancer screening guidelines from ACOG represent a welcome evolution. Given the harms and benefits associated with screening, it's appropriate that recommendations about mammography not be written in stone. The revisions bring ACOG's guidance more in line with the evidence-based recommendations of the U.S. Preventive Services Task Force (NEJM JW Womens Health Dec 2009 and Ann Intern Med 2009; 151:716). The focus on shared decision making (some might call this “negotiating”) about when to initiate screening, how often to be screened, and whether or not to undergo clinical breast examination makes sense — and should help improve healthcare for our adult female patients.

— Adapted from a Physician's First Watch article published Jun 23, 2017.

Editor Disclosures at Time of Publication

  • Disclosures for Andrew M. Kaunitz, MD at time of publication Consultant / Advisory board Allergan; Bayer AG; Merck; Mithra; Pfizer; Shionogi Royalties UpToDate Grant / Research support Therapeutics MD; Bayer; Agile; Merck; Millendo; Mithra Editorial boards Contraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health Leadership positions in professional societies North American Menopause Society (Board of Trustees)

Citation(s):

Your Comment

(will not be published)

Filtered HTML

  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Do you have any conflict of interest to disclose?
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

* Required

Reader comments are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.