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May 2024 | George M. Pikler, M.D., Ph.D., FACP, Lead Oncology Advocate N1X10

Screening for Breast Cancer: New Guidelines

Breast cancer is the second most common cancer and the second most common cause of cancer death for women in the United States. While the U.S. Preventive Services Task Force (USPSTF) has consistently recognized the value of mammography, it had previously recommended that women in their 40s make an individual decision about when to start breast cancer screening based on their health history and preferences.

On April 30, 2024, the USPSTF, which is an independent task force comprised of national experts in disease prevention and evidence-based medicine, published a final recommendation statement on screening for breast cancer for women at average risk of breast cancer, as well as for those with a family history of breast cancer and those with dense breasts. It lowered the previously recommended screening age for all women from 50 to 40 and said women up to age 74 benefit from biennial breast cancer screening. The recommendation does not apply to people who have a personal history of breast cancer, who are at very high risk of breast cancer due to certain genetic markers or a history of high-dose radiation therapy to their chest at a young age, or who have had a high-risk lesion on previous biopsies.

“More women in their 40s have been getting breast cancer, with rates increasing about 2% each year, so this recommendation will make a big difference for people across the country,” said Task Force Chair Wanda Nicholson, MD, MPH, MBA, Senior Associate Dean for Diversity, Equity, and Inclusion and Professor of Prevention and Community Health at the Milken Institute School of Public Health at the George Washington University. “By starting to screen all women at age 40, we can save nearly 20% more lives from breast cancer overall. This new approach has even greater potential benefit for Black women, who are much more likely to die of breast cancer.”

More research on the benefits and harms of breast cancer screening and treatment in women ages 75 and older is also needed—the balance of benefits and harms may shift as women age, but there is very limited research on this group. Additionally, nearly half of all women have dense breasts, which increases their risk for breast cancer and means that mammograms may not work as well for them. In my March 2024 N1X10 Post article Promising Imaging Tool in Breast Cancer Diagnosis, I describe new screening strategies to overcome the dense tissue-related limitation of mammography.

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Erica

Erica Cross, PA

PA

Erica is a board certified Physician Assistant. She obtained her Master’s degree in Physician Assistant studies from Our Lady of the Lake College in Baton Rouge, LA. She began practicing in 2011 and has worked clinically in Orthopedics and Dermatology. The majority of her career has been spent in a Dermatology practice where she assisted in Mohs surgery, treating various types of skin cancer. She also teaches in the medical simulation department at the University of South Alabama and enjoys every aspect of medical education.