ACS Breast Cancer Screening Guidelines

Charleston, S.C. (Oct. 20, 2015)The Medical University of South Carolina (MUSC) Breast Care Team will continue to recommend annual breast screening at age 40 in average risk patients, with follow-up screening yearly thereafter.

In comparing the new ACS guidelines to the U.S. Preventive Services Task Force (USPTF) guidelines, the key difference is that ACS recognizes that the incidence of breast cancer starts to increase at age 40, and they recommend women from age 40 to 44 be allowed to start screening mammograms (where USPTF recommends starting at age 50). ACS strongly recommends screening mammography to start at 45. The American College of Radiology (ACR) and Society of Breast Imaging (SBI) still recommend screening to start at age 40 and continue yearly. The ACS study reviews the literature that shows again that screening mammography reduces mortality by about 30 percent.

ACS recommends that at age 54 women should either continue annual screening or go to biannual screening. ACR and SBI still recommend annual screening at this age.

The new recommendation from ACS does not recommend clinical breast exam for average risk asymptomatic women of any age, as there is no data on improved outcome and this leads to an increased false positive rate.

The MUSC Breast Care Team recommends following ACR/SBI guidelines (starting screening at age 40 and annually) and that each women should discuss her individual risks for breast cancer with her physician to decide what is best for her. Individuals should be reminded that these guidelines are for women at average risk for breast cancer, not high risk. Those at high risk should discuss their screening plan with their physician.
Nurse and woman at mammography machine
Nancy DeMore, M.D., FACS, Professor and Interim Chief, Division of Surgical Oncology
BMW Endowed Chair in Cancer Research, Medical Director, MUSC Breast Program, MUSC

Abid Irshad, M.D., Professor of Radiology Director, Breast Imaging
Department of Radiology, Medical University of South Carolina

Rebecca Leddy, M.D., Assistant Professor of Radiology Co-Director, Breast Imaging
Department of Radiology, Medical University of South Carolina

American College of Radiology press release (PDF)
JAMA article regarding ACS guidelines (PDF)

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