The main change proposed by the new USPSTF recommendations is to lower the suggested starting age for routine screening mammograms from age 50 to age 40. It also recommends screening every two years and sets an age limit of 74 years.
Text of USPSTF Recommendations
The US Preventive Services Task Force (USPSTF) released a draft recommendation statement on breast cancer screening. The Task Force now recommends that all women be screened for breast cancer every two years starting at age 40 . This is a B grade . More research is needed on whether or not women with dense breasts should undergo additional screening with breast ultrasound or MRI, and on the benefits and harms of screening in women over 75 years of age.
The use of the term woman in this draft recommendation includes cisgender women and other persons who are assigned female at birth. Breast cancer is the second most common cancer and the second most common cause of cancer death among women in the United States. While the task force has consistently recognized the life-saving value of mammography , we previously recommended that women in their 40s make an individual decision about when to begin screening based on their health history and preferences. In this new recommendation, the task force now recommends that all women get tested starting at age 40 . This change could save 19% more lives.
“New, more inclusive science on breast cancer in people under 50 has allowed us to expand our previous recommendation and encourage all women to get tested every two years starting at age 40 ,” says the immediate past president. from the Task Force, Carol Mangione, MD, MSPH “This new recommendation will help save lives and prevent more women from dying from breast cancer . ”
Black women are 40 percent more likely to die from breast cancer than white women and too often develop deadly cancers at younger ages. The task force recognizes this inequity and calls for more research to understand the underlying causes and what can be done to eliminate this health disparity. “Ensuring that Black women begin screening at age 40 is an important first step, but it is not enough to improve the health inequalities we face related to breast cancer ,” says Task Force Vice Chair Wanda Nicholson, MD, MPH, MBA
“ In our draft recommendation, we underscore the importance of equitable follow-up after detection and timely, effective treatment of breast cancer and urgently call for more research on how to improve the health of Black women . ” There are many key areas where further research is essential. We need to know how best to address the health disparities faced by Black, Hispanic, Latina, Asian, American Indian, and Alaska Native women, particularly how to ensure equitable follow-up after screening.
Timely and effective treatment for breast cancer has the potential to save more lives for people who experience disparities related to racism, lack of access to care in rural communities, low income, and other factors. We also need more research on the benefits and harms of screening and treatment in women aged 75 and older.
The balance of benefits and harms may change as women age, but there is very limited research on this age population. Additionally, almost half of all women have dense breasts, which increases the risk of breast cancer and means mammograms may not work as well for them . We need more studies to show how additional screening with ultrasound or breast MRI could help women with dense breasts.
"We know that women with dense breasts are at higher risk for breast cancer, and unfortunately, mammograms don’t work as well for them ," says Task Force member John Wong, MD . "What we don’t yet know and what is urgently needed for more research is whether and how additional screening for women with dense breasts might be helpful, including through ultrasound, breast MRIs, or another thing".
This draft recommendation applies to women with an average risk of breast cancer. This includes people with a family history of breast cancer and people who have other risk factors, such as having dense breasts. It does not apply to people who have a personal history of breast cancer, who have a very high risk of breast cancer due to certain genetic markers or a history of high-dose radiation therapy to the chest at a young age, or who have had a high-risk lesion in previous biopsies.
Anyone concerned about their breast health should talk to their health care professional. The Task Force’s draft recommendation statement, draft evidence review, and draft modeling report have been posted for public comment on the Task Force’s website at https://www.uspreventiveservicestaskforce. org/ .
The Task Force (USPSTF) is a voluntary, independent panel of national experts in prevention and evidence-based medicine that works to improve the health of people across the country by generating evidence-based recommendations for clinical preventive services, such as screenings. , counseling services and preventive medications.
