RSNA has updated its position statement on breast cancer screening, aligning with the ACR’s recommendation of annual mammography starting at age 40. The guidelines emphasize the importance of early detection and individual risk assessment. However, concerns were raised regarding the USPSTF’s recommendations, which were deemed insufficient in addressing disparities and high-risk populations. The article highlights the significant decline in breast cancer mortality rates due to screening mammography since 1990. Continued research and dialogue are crucial for optimizing breast cancer screening practices.
The Radiological Society of North America (RSNA) recently updated its position statement on breast cancer screening to align with the latest recommendations from the American College of Radiology (ACR) and the United States Preventive Services Task Force (USPSTF). The revised guidelines emphasize the importance of early detection and endorse the ACR’s recommendation of annual mammography screening for women starting at the age of 40, with no upper age limit, to maximize life-saving outcomes in breast cancer.
One significant update in the ACR’s guidelines is the lowering of the recommended age for women at increased risk to be assessed for earlier screening. Previously set at age 30, the revised guidelines now suggest that women with increased risk should undergo assessment for earlier screening starting at age 25. This adjustment acknowledges the importance of proactive monitoring and tailored screening protocols for women who may be more susceptible to developing breast cancer.
Dr. Stamatia V. Destounis, chair of the ACR Breast Commission and a member of the RSNA Public Information Advisors Network, emphasized the ACR’s stance on screening based on individual risk factors rather than solely considering age. According to Dr. Destounis, the ACR guidelines recommend annual mammography for average-risk patients starting at age 40, with no predefined upper age limit. The guidelines also stress the importance of supplemental screening for high-risk patients, including those with a family history of breast cancer or dense breast tissue. Dr. Destounis criticized the USPSTF’s failure to recommend any supplemental screening for these specific groups.
In a draft statement released recently, the USPSTF recommends biennial screening mammography for women aged 40 to 74 years. However, the revised recommendation concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography for women aged 75 years or older. The USPSTF is seeking public comment on this statement until June 6 to gather further insights and perspectives.
Dr. Destounis expressed concerns regarding the USPSTF’s guidelines, stating that they do not go far enough in advocating for breast cancer screening. She highlighted the fact that black women are 42% more likely to die from breast cancer compared to white women and argued that the USPSTF’s recommendations could exacerbate these disparities by allowing cancers in high-risk women to advance for another year.
The primary goal of breast cancer screening is to detect cancer at an early stage, when it is still small and localized, before it causes noticeable symptoms or spreads to other parts of the body. Early detection plays a crucial role in reducing the morbidity and mortality associated with breast cancer. Data from the 2015 National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program shows that since 1990, the breast cancer death rate in the U.S., which had remained stagnant for the preceding 50 years, has decreased by 43%. This significant decline is primarily attributed to the widespread adoption of screening mammography.
