WB: Screening Recommendations Updated for Increased Breast Cancer Risk

Women with higher-than-average breast cancer risk should initiate screening at a younger age, starting annual mammography at ages 25 to 40 years in addition to risk-based supplemental magnetic resonance imaging screening, according to a position statement issued by the American College of Radiology and published online May 5 in the Journal of the American College of Radiology.

Debra L. Monticciolo, M.D., from Massachusetts General Hospital/Harvard Medical School in Boston, and colleagues developed an updated guideline on imaging women at higher-than-average risk for breast cancer based on an extensive literature review and new data on imaging modalities.

The authors note that for all women, risk assessment should take place by age 25 years to allow for planning of appropriate screening. This is especially important for Black women, those of Ashkenazi Jewish descent, and those with a higher risk for genetic mutations. Women with genetics-based increased risk or with a calculated lifetime risk of 20 percent or more should have annual digital mammography with or without digital breast tomosynthesis starting at age 30 years. If mutation carriers are screened annually with magnetic resonance imaging starting at age 25 years, they can delay annual mammography screening until age 40 years. Annual mammography beginning at age 25 years or eight years after radiation therapy (whichever is later) is recommended for women who have received a cumulative dose of chest radiation of 10 Gy or more before age 30 years. Annual digital mammography with or without digital breast tomosynthesis should be started at the time of diagnosis for women diagnosed with breast cancer, atypia, or lobular neoplasia before age 40 years.