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ACP Recasts Breast Screening With Biennial Mammograms at Ages 50–74

The move shifts screening to tailored choices by age and risk so clinicians can balance benefits with potential harms.

Overview

  • The American College of Physicians, which released its guidance Friday, recommends biennial mammograms for asymptomatic, average-risk women ages 50 to 74, a group without prior breast cancer, high-risk genes or past high-dose chest radiation.
  • For women ages 40 to 49, ACP calls for a discussion with a doctor about personal risk and preferences because false positives, extra tests and radiation may outweigh uncertain benefits.
  • ACP advises women who are 75 or older or who have limited life expectancy to discuss stopping routine screening because benefits beyond age 74 are reduced or unclear.
  • For women with dense breasts at average risk, ACP says doctors can consider digital breast tomosynthesis, also called 3D mammography, and it advises against routine screening MRI or ultrasound.
  • The American College of Radiology responded Friday with a statement opposing the guidance and urging annual screening starting at 40, highlighting ongoing differences among major medical groups that doctors must reconcile in patient counseling.