Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update from the American Cancer Society
By K. Oeffinger, Elizabeth T. H. Fontham, Ruth Etzioni, Abbe Herzig, J. Michaelson, Y. Shih, L. Walter, T. Church, C. Flowers, S. J. LaMonte and 9 more. Journal of the American Medical Association (JAMA), 2015
1,520 citations recorded by the source corpus.
Importance Breast cancer is a leading cause of premature mortality among U.S. women. Early detection has been shown to be associated with reduced breast cancer morbidity and mortality. This report updates the American Cancer Society (ACS) 2003 breast cancer screening guideline for women at average risk for breast cancer. Process The ACS commissioned a systematic evidence review of the breast cancer screening literature to inform the update, and a supplemental analysis of mammography registry data to address questions related to the screening interval. Formulation of recommendations was based on the quality of the evidence and judgment (incorporating values and preferences) about the balance of benefits and harms. Evidence Synthesis Mammography screening in women aged 40–69 years is associated with a reduction in breast cancer deaths across a range of study designs, and inferential evidence supports breast cancer screening in women who are age 70 years and older and are in good health. Estimates of the cumulative lifetime risk of false positive exams are greater if screening begins at younger ages due to the greater number of mammograms, as well as the higher recall rate in younger women. The quality of the evidence for overdiagnosis is not sufficient to estimate a lifetime risk with confidence. Analysis examining the screening interval demonstrates more favorable tumor characteristics when premenopausal women are screened annually vs. biennially. Evidence does not support routine clinical breast examination as a screening method for average risk women. Recommendations The ACS recommends that women with an average risk of breast cancer should undergo regular screening mammography starting at age 45 years (strong recommendation). Women who are ages 45 to 54 years should be screened annually (qualified recommendation). Women who are age 55 years and older should transition to biennial screening or have the opportunity to continue screening annually (qualified recommendation). Women should have the opportunity to begin annual screening between the ages of 40 and 44 years (qualified recommendation). Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or more (qualified recommendation). The ACS does not recommend clinical breast examination for breast cancer screening among average-risk women at any age (qualified recommendation).
Subfields: Oncology, Pathology and Forensic Medicine, Pulmonary and Respiratory Medicine
View Paper: https://www.semanticscholar.org/paper/19afce30ab73b631abb1e7930149d5acf21e5de4
How researchers see this paper
The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.
In Oncology
In Pathology and Forensic Medicine
In Pulmonary and Respiratory Medicine
Citations in the corpus
- Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening (2018, methodology): “In addition, the agespecific, incidence-based person-years of life lost, an indicator of premature mortality, also was similar for women aged 45 to 49 years and aged 50 to 54 years (approximately 15% of the total annual person-years of life lost for all women was attributable to a diagnosis of breas”
- Deep Multi-instance Networks with Sparse Label Assignment for Whole Mammogram Classification (2016, background): “However, screenings are usually associated with high false positive rates, high variability among different clinicians, and over-diagnosis of insignificant lesions [17].”
- Deep Learning to Improve Breast Cancer Detection on Screening Mammography (2017, background): “women [1] and screening mammography has been found to reduce mortality [2].”
- Adversarial Deep Structural Networks for Mammographic Mass Segmentation (2016, background): “Mammogram screening has been demonstrated to be an effective way for early detection and diagnosis, which can significantly decrease breast cancer mortality [23].”
- Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American Cancer Society (2018, methodology): “The ACS follows a protocol for developing and disseminating guidelines that is designed to maintain transparency, consistency, and rigor.(27,28) This process includes the use of systematic evidence reviews on the topic, consideration of the overall balance of benefits and harms of interventions and ”