Risk-Based Mammography Screening: An Effort to Maximize the Benefits and Minimize the Harms

Editorials1 May 2012Risk-Based Mammography Screening: An Effort to Maximize the Benefits and Minimize the HarmsOtis W. Brawley, MDOtis W. Brawley, MDFrom American Cancer Society, Atlanta, GA 30303.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-9-201205010-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail All major organizations publishing breast cancer screening recommendations agree that women aged 50 to 74 years should get routine mammographic screening (1). However, there is debate about whether screening should be done every year or every 2 years. There is also substantial disagreement about whether all women in their 40s should get routine screening.It is widely accepted that screening women aged 40 to 49 years can reduce mortality, but some concern exists about the high ratio of harm to benefit in this age group (1, 2). If screening efforts could focus on women at greatest risk for breast cancer, ...References1. Smith RA, Cokkinides V, Brooks D, Saslow D, Shah M, Brawley OW. Cancer screening in the United States, 2011: a review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin. 2011;61:8-30. [PMID: 21205832] CrossrefMedlineGoogle Scholar2. US Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151:716-26, W-236. [PMID: 19920272] MedlineGoogle Scholar3. van Ravesteyn NT, Miglioretti DL, Stout NK, Lee SJ, Schechter CB, Buist DS, et al. Tipping the balance of benefits and harms to favor screening mammography starting at age 40 years. A comparative modeling study of risk. Ann Intern Med. 2012;156:609-17. LinkGoogle Scholar4. Nelson HD, Zakher B, Cantor A, Fu R, Griffin J, O'Meara ES, et al. Risk factors for breast cancer for women aged 40 to 49 years. 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Ballard-Barbash R, Taplin SH, Yankaskas BC, Ernster VL, Rosenberg RD, Carney PA, et al. Breast Cancer Surveillance Consortium: a national mammography screening and outcomes database. AJR Am J Roentgenol. 1997;169:1001-8. [PMID: 9308451] CrossrefMedlineGoogle Scholar19. Nicholson BT, LoRusso AP, Smolkin M, Bovbjerg VE, Petroni GR, Harvey JA. Accuracy of assigned BI-RADS breast density category definitions. Acad Radiol. 2006;13:1143-9. [PMID: 16935726] CrossrefMedlineGoogle Scholar20. Hoskins LM, Roy KM, Greene MH. Toward a new understanding of risk perception among young female BRCA1/2 "previvors". Fam Syst Health. 2012;30:32-46. [PMID: 22429077] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Otis W. Brawley, MDAffiliations: From American Cancer Society, Atlanta, GA 30303.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-0761.Corresponding Author: Otis W. Brawley, MD, American Cancer Society, 250 Williams Street, Atlanta, GA 30303; e-mail, otis.[email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTipping the Balance of Benefits and Harms to Favor Screening Mammography Starting at Age 40 Years Nicolien T. van Ravesteyn , Diana L. Miglioretti , Natasha K. Stout , Sandra J. Lee , Clyde B. Schechter , Diana S.M. Buist , Hui Huang , Eveline A.M. Heijnsdijk , Amy Trentham-Dietz , Oguzhan Alagoz , Aimee M. Near , Karla Kerlikowske , Heidi D. Nelson , Jeanne S. Mandelblatt , and Harry J. de Koning Risk Factors for Breast Cancer for Women Aged 40 to 49 Years Heidi D. Nelson , Bernadette Zakher , Amy Cantor , Rongwei Fu , Jessica Griffin , Ellen S. O'Meara , Diana S.M. Buist , Karla Kerlikowske , Nicolien T. van Ravesteyn , Amy Trentham-Dietz , Jeanne S. Mandelblatt , and Diana L. 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