USPSTF finalizes breast cancer screening guidelines

The US Preventive Task Force recently finalized their update to the guidelines on breast cancer screening, despite the debate that arose when they were first announced.

Related: Are the benefits of mammography overstated?

Contemporary OB/GYN reached out to editorial board member Ilana Cass, MD for comment.

The USPSTF has updated their 2009 breast cancer screening guidelines reaffirming the recommendation for biennial mammogram screening in women aged 50-74.  This recommendation was classified as a B grade based upon the data to suggest a moderate net benefit of screening mammography in this age group.  The guidelines endorse individualized decision-making mammography screening in women ages 40-49 based upon their preferences, values and health history with a C recommendation, stating there is moderate certainty that the benefit is small.  By comparison, ACOG, ACS (American Cancer Society) and the NCCN endorse annual screening at the age of 40.  Part of the discrepancy in these guidelines relates to the emphasis placed upon mortality reduction of mammography.  Opponents of the USPSTF guidelines argue that annual mammography can enhance the earlier detection of cancer when treatment options may be more conservative, with fewer side effects and less onerous for patients.  The benefits of annual mammography should factor in other important metrics such as improved outcomes due to potentially earlier diagnosis, smaller tumors and the need for less adjuvant treatments.