Breast Cancer screening; further updates

The IARC (International Agency for Research on Cancer) issued an updated evidence review for recommendations on Breast Cancer screening.  This review was important given “improvements in treatment of later stage breast cancers and new evidence”.  In general, their summary suggests:

1.  Screening mammo (1-2 year intervals) is beneficial for ages 50-74.

2.  Screening mammo for ages 40-49 was “less effective” and of unclear benefit, mammo’s for those under 40 was not recommended.

3.  Adjunctive imaging (MRI, U/S) to improve screening in high risk individuals (BRCA+ and elevated breast density) increased sensitivity for finding CA at the risk of increased false positives and thus the evidence was deemed “inadequate” to recommend these modalities routinely.

4.  The risks for screening include overdiagnosis, false positives requiring invasive workup and radiation induced cancer.

The summary as published in NEJM link below did not suggest specific guidelines and as always this “generalized data” needs to be taken in context individually in discussion with one’s personal physician.

NEJM 2015


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