Mammographic Screening: General Population
Breast cancer screening in the average-risk population is based on periodic mammograms in asymptomatic women aiming the early detection of the disease. Mammographic screening, coupled with therapeutic advances, is associated with the reduction in breast cancer mortality observed in many countries. The detection of small asymptomatic tumors also offers a greater number of therapeutic choices; it increases the chance of conservative treatment and reduces the need for chemotherapy.
- 1.Marmot MG, Altman DG, Cameron DA, Dewar JA, Thompson SG, Wilcox M. The benefits and harms of breast cancer screening: an independent review. Br J Cancer. 2013;108(11):2205–40. An extensive and detailed independent systematic review of the literature by the Independent UK Panel commissioned by Cancer Research UK and the Department of Health (England) to assess the benefits and adverse effects of breast cancer screeningCrossRefGoogle Scholar
- 2.Myers ER, Moorman P, Gierisch JM, Havrilesky LJ, Grimm LJ, Ghate S, et al. Benefits and harms of breast cancer screening: a systematic review. JAMA. 2015;314(15):1615–34. An extensive systematic review of the literature commissioned by the American Cancer Society to synthesize available evidence on the association of mammographic screening and clinical breast examination with breast cancer mortality, overdiagnosis, false positives, and life expectancy. It is used to support its new recommendations (Article 3)CrossRefGoogle Scholar
- 3.Oeffinger KC, Fontham ET, Etzioni R, Herzig A, Michaelson JS, Shih YC, et al. Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA. 2015;314(15):1599–614. New recommendations for breast cancer screening by the American Cancer Society: the ACS recommends that women in the general population should undergo regular mammographic screening from the age of 45 on (strong recommendation). Between 45 and 54 years old, women should be screened annually (qualified recommendation). Women at age 55 or older should move to biennial screening or have the opportunity to continue their annual screening (qualified recommendation). Women should have the opportunity to initiate annual screening between the ages of 40 and 44 (qualified recommendation). Women should continue screening mammograms provided that their overall health is good and they have a life expectancy of 10 years or more (qualified recommendation). ACS does not recommend clinical breast examination for screening for breast cancer in the general population at any age (qualified recommendation)CrossRefGoogle Scholar
- 4.Siu AL, U.S. Preventive Services Task Force. Screening for breast cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 2016;164(4):279–96. Update of the USPSTF recommendations for the screening of breast cancer. The USPSTF recommends bi-annual mammographic screening for women aged 50–74 (Recommendation B). The decision to initiate mammographic screening in women before age 50 should be individualized. Women who place a greater value on potential benefit than potential adverse effects may choose to start the bi-annual screening between 40 and 49 years old (Recommendation C). The USPSTF concludes that current evidence is insufficient to assess the balance between benefit and adverse effects of mammographic screening in women aged 75 years or older (Statement I). The USPSTF concludes that current evidence is insufficient to assess the benefits and adverse effects of digital breast tomosynthesis as the primary method of screening for breast cancer (Statement I)CrossRefGoogle Scholar
- 5.Urban LABD, Chala LF, Bauab SP, Schaefer MB, dos Santos RP, Maranhão NMA, et al. Recomendações do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, da Sociedade Brasileira de Mastologia e da Federação Brasileira de Ginecologia e Obstetrícia para rastreamento do câncer de mama por imagem. Radiol Bras. 2017;50(4):244–9. Recommendations of the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Society of Mastology and the Brazilian Federation of Gynecology and Obstetrics for the screening of breast cancer. The authors discuss the risks and benefits according to age range and risk of breast cancer. Annual mammographic screening is recommended for women in the general population aged 40–74 years old. Above 75 years old, it should be reserved for those who have a life expectancy of more than 7 years. Complementary screening with ultrasound should be considered for women with dense breasts. Tomosynthesis is a form of mammography that can be considered for screening for breast cancer when availableGoogle Scholar