If, after this careful assessment and discussion, a woman’s breast cancer risk is not high, current evidence indicates that the benefit of screening mammography is small. For this age group, there is a greater risk of false-positive screening results and consequently of undergoing unnecessary or harmful follow-up procedures. Furthermore, screening may lead to overdiagnosis, resulting in non-essential treatment of lesions that would not have caused harm in a woman’s lifetime. Some women may still express an interest to be screened based on their values and preferences, and in this circumstance, care providers should engage in shared decision-making to support women in making an informed choice. As always, clinicians need to be aware of changes in the balance of evidence on risk and benefit and support women in understanding this evidence. High quality materials to assist these discussions are available through the Canadian Task Force on Preventive Health Care.
Sources:
Canadian Task Force of Preventive Health Care, et al. Recommendations on screening for breast cancer in women aged 40-74 years who are not at increased risk for breast cancer. CMAJ. 2018 December 10;190:E1441-51. doi: 10.1503/cmaj.180463 PMID: 30530611
Canadian Task Force on Preventive Health Care. Breast Cancer Update: Key Recommendations [Internet]. 2018.
Canadian Task Force on Preventive Health Care. Breast Cancer Screening for Women Not at Increased Risk. Patient Tool – Ages 40-49 [Internet]. 2018.
Ringash J, et al. Preventive health care, 2001 update: screening mammography among women aged 40-49 years at average risk of breast cancer. CMAJ. 2001 Feb 20;164(4):469-76. PMID: 11233866.
US Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009 Nov 17;151(10):716-26, W-236. PMID: 19920272.
Related Resources:
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