ACR releases breast cancer screening criteria

The American College of Radiology's (ACR) expert panel on breast imaging has published appropriateness criteria for breast cancer screening in the November issue of the Journal of the American College of Radiology.

The researchers, led by Martha Mainiero of Brown University, outlined the college's guidelines (JACR, November 2017, Vol. 14:11S, pp. S383-S390):

• Women at average risk for breast cancer should begin screening mammography and/or digital breast tomosynthesis (DBT) at age 40.
• Ultrasound may be a useful adjunct to mammography for women with dense breasts; women should consider the balance between increased cancer detection and risk of a false positive.
• For women at intermediate risk of breast cancer, ultrasound or MRI may be indicated as an adjunct to mammography and/or DBT, depending on risk factors.
• For women at high risk of the disease, annual screening with breast MRI is recommended in addition to mammography and/or DBT.
• For women at high risk of breast cancer due to prior chest radiation between the ages of 10 and 30, mammography is recommended starting eight years after radiation therapy but not before age 25.
• For women with a genetic disposition to breast cancer, annual screening mammography is recommended 10 years earlier than the affected relative at the time of diagnosis, but not before age 30.

Mainiero's group used 65 references published between 2005 and 2017 to establish the criteria.