US Preventive Services Task Force recommends biennial screening mammography from 40 to 74

The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women ages 40 to 74 years. This recommendation forms the basis of a draft recommendation statement published online May 9.

Amy Trentham-Dietz, Ph.D., from the U.S. Department of Health and Human Services in Rockville, Maryland, and colleagues provided the USPSTF with updated model-based estimates of the benefits and harms of breast cancer screening strategies. The researchers identified five efficient screening strategies that yielded the highest breast cancer mortality reduction and life-years gained (LYG). Efficient strategies included digital breast tomosynthesis and biennial screening (ages 50 to 74, 40 to 79, or 45 to 79 years), annual screening (ages 40 to 79 years), and a hybrid combination of intervals (annual at ages 40 to 49 years, then biennial at ages 50 to 79 years). For a cohort of 1,000 average-risk 40-year-old women of all races, estimated median breast cancer mortality reduction across these strategies ranged from 25.4 to 41.7 percent; LYG ranged from 120.8 to 229.7 and deaths averted varied from 6.7 to 11.5.

For women ages 40 to 74 years, the USPSTF recommends biennial screening mammography (B recommendation). For women aged 75 years and older, the current evidence is insufficient to assess the balance of benefits and harms of screening mammography (I statement). The evidence is also insufficient to assess the benefits and harms of supplemental screening for breast cancer using breast ultrasonography or magnetic resonance imaging in women identified with dense breasts on an otherwise negative screening mammogram (I statement).

"[We] urge the USPSTF to go further to recommend annual mammography screening for all average-risk women ages 40 and older," the American College of Radiology (ACR) and Society of Breast Imaging (SBI) said in a joint statement. "The USPSTF, ACR, SBI, American Cancer Society, and others all agree that the most lives are saved with this annual approach. Medical experts should clear the confusion caused by differing recommendations and agree to recommend yearly mammography for average-risk women starting at age 40."

The draft evidence review and recommendation statement are posted for public comment. Comments can be submitted from May 9 through June 5, 2023.

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