Breast Cancer Screening Guidelines Need Improvement

Assessing breast density and cancer risk could potentially guide how frequently a patient should receive a mammogram, but shared decision making guidelines are not as concrete as they need to be for patients and physicians to create an effective plan, a recent study suggests.

Clinical guidelines recommend biennial screenings and stress shared decision making in regards to frequency, according to the study. The shared decision making should take into account patient preferences, breast cancer risk, and breast density, according to a study published by Annals of Internal Medicine.

There are currently limited data to provide guidance for these decisions. Researchers in the study found that average-risk patients with lower breast density may benefit from screening every 3 years, since it is just as effective, but provides better benefits than screening every 2 years.

Triennial screenings are also more cost effective than the recommended biennial screening for women 50- to 74-years-old with average risk. However, high-risk patients with dense breasts may see the most benefit from biennial screenings.

In the current study, researchers used 3 models to evaluate outcomes using screening intervals among subgroups of patients based on age, risk, and breast density, according to the study. Researchers created new guidelines based on their factors, which showed that patients who are 50-years-old and above with lower breast density should receive triennial screenings.

This could reduce the amount of false-positives, biopsies, and overdiagnosis of breast cancer. Researchers did not find that triennial screenings would increase breast cancer-related deaths.

For patients with higher breast density, researchers recommend an annual screening. Investigators believe these findings could assist patients and physicians in shared decision making, and creating patient specific screening intervals.