Skip Navigation
American College of Physicians Logo
  • Subscribe
  • Submit a Manuscript
  • Sign In
    Sign in below to access your subscription for full content
    INDIVIDUAL SIGN IN
    Sign In|Set Up Account
    You will be directed to acponline.org to register and create your Annals account
    INSTITUTIONAL SIGN IN
    Open Athens|Shibboleth|Log In
    Annals of Internal Medicine
    SUBSCRIBE
    Subscribe to Annals of Internal Medicine.
    You will be directed to acponline.org to complete your purchase.
Annals of Internal Medicine Logo Menu
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives
  • Author Info
Advanced Search
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Summaries for Patients |16 April 2019

Breast Cancer Screening in Average-Risk Women Free

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
This article was published at Annals.org on 9 April 2019.

  • From: 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. Ann Intern Med. 2019;170:547-60. doi:10.7326/M18-2147


Summaries for Patients are a service provided by Annals and the ACP Center for Patient Partnership in Healthcare to help patients better understand the complicated and often mystifying language of modern medicine.
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
×
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Jump To
  • Full Article
  • FULL ARTICLE
  • FULL ARTICLE
    • Who developed these recommendations?
    • What is the problem and what is known about it so far?
    • How did the ACP develop these recommendations?
    • What are the benefits and harms of breast cancer screening in average-risk women?
    • What does “average-risk” mean?
    • What does the ACP suggest that patients and doctors do?
    • Questions you may want to ask your doctor
  • Figures
  • Tables
  • Supplements
  • Audio/Video
  • Summary for Patients
  • Clinical Slide Sets
  • CME / MOC
  • Comments
  • Twitter Link
  • Facebook Link
  • Email Link
More
  • LinkedIn Link

Who developed these recommendations?

The American College of Physicians (ACP) developed these recommendations. The ACP is a professional organization for internal medicine doctors, who specialize in health care for adults.

What is the problem and what is known about it so far?

Breast cancer is the most common cancer in women. It is the fourth leading cause of cancer death in the United States. Breast cancer screening can find signs of cancer before symptoms begin, when it is more likely to be curable. The screening test is a mammogram, a special kind of x-ray most commonly used to find breast cancer. Different organizations have different recommendations about ages to start and stop breast cancer screening and how often to do screening tests.

How did the ACP develop these recommendations?

The ACP Clinical Guidelines Committee reviewed selected guidelines on breast cancer screening from around the world. They evaluated the quality of these guidelines to help doctors and patients make decisions about breast cancer screening in women who are at average risk (which is most women). The guidance does not address women at high risk for developing breast cancer.

What are the benefits and harms of breast cancer screening in average-risk women?

Breast cancer screening can lead to early detection and treatment, which may reduce death from breast cancer, generally in women aged 50 to 69 years. However, screening tests may also cause harms. These harms can include overdiagnosis and overtreatment, which occur when breast cancer is detected in women who would never have been bothered by or died from cancer. Such women may experience harms, including emotional and physical harms (for example, from chemotherapy), without benefit. Other harms include “false-positive” results (when an abnormality is found that is not cancer) and the pain and worry from follow-up tests, such as unnecessary biopsies. Radiation exposure from mammograms also increases with the number of mammograms a woman has over her lifetime, which could increase her risk for radiation-associated breast cancer.

What does “average-risk” mean?

For the purpose of these recommendations, an “average-risk” woman is one who does not have any of the following:

  • personal history of breast cancer;

  • previously diagnosed high-risk breast lesion;

  • any genetic mutation known to increase the risk for breast cancer; or

  • history of exposure to radiation to the chest in childhood.

What does the ACP suggest that patients and doctors do?

Average-risk women between the ages of 40 and 49 years should discuss the benefits and risks of breast cancer screening with their doctors. These patients should consider the facts along with their own personal values and preferences about screening to make an individualized decision. The potential harms of screening outweigh the benefits for most women in this age bracket.
Doctors should offer breast cancer screening with a mammogram every 2 years to average-risk women between the ages of 50 and 74 years.
Doctors should stop screening for breast cancer in average-risk women aged 75 years or older or in women with a life expectancy of 10 years or less.
Doctors should not use clinical breast examinations to screen for breast cancer.

Questions you may want to ask your doctor

  • What is my personal risk for breast cancer?

  • When should I start screening for breast cancer?

  • What are the benefits of screening, and do they vary by age?

  • What harms from breast cancer screening should I consider?

  • If I undergo screening, how often should I be screened?

  • When should I stop breast cancer screening?

This feature is available only to Registered Users

Subscribe/Learn More
Submit a Comment

0 Comments

PDF
Not Available
Citations
Citation

Breast Cancer Screening in Average-Risk Women. Ann Intern Med. 2019;170:I–18. [Epub ahead of print 9 April 2019]. doi: https://doi.org/10.7326/P19-0007

Download citation file:

  • Ris (Zotero)
  • EndNote
  • BibTex
  • Medlars
  • ProCite
  • RefWorks
  • Reference Manager

© 2020

×
Permissions

Published: Ann Intern Med. 2019;170(8):I-18.

DOI: 10.7326/P19-0007

Published at www.annals.org on 9 April 2019

©
2019 American College of Physicians
0 Citations
Advertisement

See Also
Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians
View MoreView Less

Related Articles
Breast Cancer Screening and Diagnosis: A Synopsis of the European Breast Guidelines
Annals of Internal Medicine; 172 (1): 46-56
What Do the European Breast Cancer Screening Guidelines Portend for U.S. Practice?
Annals of Internal Medicine; 172 (1): 65-66
Annals On Call - Making Sense of Breast Cancer Screening Guidelines
Annals of Internal Medicine; 171 (8): OC1
Methods for Development of the European Commission Initiative on Breast Cancer Guidelines: Recommendations in the Era of Guideline Transparency
Annals of Internal Medicine; 171 (4): 273-280
View MoreView Less

Journal Club
Review: In women ≥ 40 years of age at average risk, breast cancer screening causes some harms
Annals of Internal Medicine; 164 (8): JC39
Annual mammography screening did not reduce long-term breast cancer mortality in women 40 to 59 years of age
Annals of Internal Medicine; 160 (10): JC7
4% lidocaine gel applied to the breasts before screening mammography reduced discomfort
Annals of Internal Medicine; 149 (10): JC5-9
View MoreView Less

Related Point of Care
Breast Cancer Screening and Prevention
Annals of Internal Medicine; 164 (11): ITC81-ITC96
Breast Cancer Screening and Prevention
Annals of Internal Medicine; 152 (7): ITC4-1
View MoreView Less

Related Topics
Breast Cancer
Cancer Screening/Prevention
Hematology/Oncology
Prevention/Screening

Breast Cancer, Cancer Screening/Prevention, Hematology/Oncology, Prevention/Screening.

PubMed Articles
Views on Precision Medicine among Health Professionals in Korea: A Mixed Methods Study.
Yonsei Med J 2020;61(2):192-197.
An alternative to standard lumpectomy: a 5-year case series review of oncoplastic breast surgery outcomes in a Canadian setting
Can J Surg 2020;63(1):E46-E51.
View More

Results provided by: PubMed

Advertisement
CME/MOC Activity Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
The Comments Feature Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
link to top

Content

  • Home
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives

Information For

  • Author Info
  • Reviewers
  • Press
  • Readers
  • Institutions / Libraries / Agencies
  • Advertisers

Services

  • Subscribe
  • Renew
  • Alerts
  • Current Issue RSS
  • Latest RSS
  • In the Clinic RSS
  • Reprints & Permissions
  • Contact Us
  • Help
  • About Annals
  • About Mobile
  • Patient Information
  • Teaching Tools
  • Annals in the News
  • Share Your Feedback

Awards and Cover

  • Personae (Cover Photo)
  • Junior Investigator Awards
  • Poetry Prize

Other Resources

  • ACP Online
  • Career Connection
  • ACP Advocate Blog
  • ACP Journal Wise

Follow Annals On

  • Twitter Link
  • Facebook Link
acp link acp
silverchair link silverchair

Copyright © 2020 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
INSTITUTIONAL SIGN IN
Open Athens|Shibboleth|Log In
Annals of Internal Medicine
PURCHASE OPTIONS
Buy This Article|Subscribe
You will be redirected to acponline.org to sign-in to Annals to complete your purchase.
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×