ACR Appropriateness Criteria® Breast Cancer Screening

Breast cancer screening recommendations are based on risk factors. For average-risk women, screening mammography and/or digital breast tomosynthesis is recommended beginning at age 40. Ultrasound (US) may be useful as an adjunct to mammography for incremental cancer detection in women with dense bre...

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Bibliographic Details
Published in:	Journal of the American College of Radiology Vol. 14; no. 11; pp. S383 - S390
Main Authors:	Mainiero, Martha B., Moy, Linda, Baron, Paul, Didwania, Aarati D., diFlorio, Roberta M., Green, Edward D., Heller, Samantha L., Holbrook, Anna I., Lee, Su-Ju, Lewin, Alana A., Lourenco, Ana P., Nance, Kara J., Niell, Bethany L., Slanetz, Priscilla J., Stuckey, Ashley R., Vincoff, Nina S., Weinstein, Susan P., Yepes, Monica M., Newell, Mary S.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-11-2017
Subjects:	Age Factors Appropriate Use Criteria Appropriateness Criteria AUC Breast Cancer Breast MRI Breast Neoplasms - diagnostic imaging Breast US Diagnostic Imaging - methods Early Detection of Cancer Evidence-Based Medicine Female Humans Mammography Risk Factors Screening Societies, Medical United States Screening Appropriate Use Criteria Breast MRI Mammography Breast Cancer Appropriateness Criteria Breast US AUC
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Summary:	Breast cancer screening recommendations are based on risk factors. For average-risk women, screening mammography and/or digital breast tomosynthesis is recommended beginning at age 40. Ultrasound (US) may be useful as an adjunct to mammography for incremental cancer detection in women with dense breasts, but the balance between increased cancer detection and the increased risk of a false-positive examination should be considered in the decision. For intermediate-risk women, US or MRI may be indicated as an adjunct to mammography depending upon specific risk factors. For women at high risk due to prior mantle radiation between the ages of 10 to 30, mammography is recommended starting 8 years after radiation therapy but not before age 25. For women with a genetic predisposition, annual screening mammography is recommended beginning 10 years earlier than the affected relative at the time of diagnosis but not before age 30. Annual screening MRI is recommended in high-risk women as an adjunct to mammography. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Instructional Material/Guideline-2 ObjectType-Feature-3 content type line 23
ISSN:	1546-1440 1558-349X
DOI:	10.1016/j.jacr.2017.08.044