The new United States Preventive Services Task Force (USPSTF) Breast Cancer Screening Recommendations are a step in the right direction. However, the American College of Radiology® (ACR®) and Society of Breast Imaging (SBI) urge the USPSTF to go further to recommend annual mammography screening for all average-risk women ages 40 and older.
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.
Mounting evidence shows that Black and other minority women, Jewish women, and others develop and die from breast cancer prior to age 50 — or even age 40 — more often than white women. As our 2021 guidelines for average-risk women and our new (2023) guidelines for high-risk women make clear, potentially giving cancer another year to advance may particularly impact these women.
The ACR and SBI also recommend that all women have a risk assessment by age 25, as called for in new ACR/SBI guidelines for high-risk women and discuss with their doctor whether earlier screening with mammography and/or MRI is needed.
Involving factors such as sex assigned at birth, hormone use and surgical histories place transgender persons at increased risk for breast cancer. Biological females transitioning to male who do not undergo mastectomy remain at their previous risk for breast cancer and should continue to be screened as such.
As outlined in current (2021) ACR/SBI recommendations for average-risk women, due to hormone use, biological males transitioning to female are at increased risk for breast cancer compared to other males and should speak with their doctor about their breast cancer risk.
The societies also recommend that women continue screening past age 74, unless severe comorbidities limit life expectancy.