Breast Cancer Screening

ACP Releases New Breast Cancer Screening Guidelines

The American College of Physicians (ACP) has released new recommendations for breast cancer screening, stating that women aged 50 to 74 years with average risk should be screened via mammography biennially.1

“These guidelines echo those of the American Cancer Society, the American Society of Breast Surgeons, and the US Preventative Services Task Force, who all recommend every other year screening for women age 50 to 74 who are at ‘average risk’ for developing breast cancer,” said Deanna Attai, MD, assistant clinical professor in the department of surgery at David Geffen School of Medicine at UCLA, in a press release.2

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Other points in the ACP’s guidance statement include:

  • Clinicians are recommended to discuss whether to screen for breast cancer with mammography before age 50 years, as well as the benefits and harms of screening, among average-risk women aged 40 to 49 years. The authors of the guideline noted that, in the majority of women aged 40 to 49 years, the potential harms of screening outweigh the benefits.
  • Clinicians are recommended to discontinue screening in average-risk women aged 75 years or older or in women with a life expectancy of 10 years or less.
  • In average-risk women of all ages, clinical breast examination is not recommended as a modality of breast cancer screening.

Aside from skin cancer, breast cancer is the most common cancer among American women, the CDC says. Sex and age are among the top risk factors for breast cancer, as most cases are diagnosed in women older than age 50 years.3

“Mammograms work well in women aged 50 to 74 because as women age and go through menopause, the density of the breast usually decreases, so mammograms can ‘see’ cancers better,” Dr Attai said.2

The ACP’s statement conflicts with some other recommendations, which state women with average risk should receive annual mammography screenings beginning at age 40 years. However, the harms of screening in this age group – such as an increased risk of receiving a “false positive” – likely outweigh the benefits, Dr Attai noted.

—Christina Vogt


1. Qaseem A, Lin JS, Mustafa RA, Horwitch CA, Wilt TJ; Clinical Guidelines Committee of the American College of Physicians. Screening for breast cancer in average-risk women: a guidance statement from the American College of Physicians [Published online April 9, 2019]. Ann Intern Med. doi:10.7326/M18-2147.

2. ACP breast cancer screening guideline update: Breast cancer surgeon/expert available [press release]. University of California, Los Angeles (UCLA), Health Sciences. April 8, 2019. Accessed on April 9, 2019.

3. Breast cancer. Centers for Disease Control and Prevention. Page last reviewed May 29, 2018. Accessed on April 9, 2019.