Updated breast cancer screening guidelines from the ACR and SBI highlight the importance of annual screening for all women
- Starting screening at 40 for all women
- The benefit of a risk assessment by 30
- Addressing underserved and overlooked populations including transgender people and minority women’
The American College of Radiology (ACR) and Society of Breast Imaging (SBI) jointly published updated breast cancer screening guidelines in June 2021 in the Journal of the American College of Radiology (JACR). The updated guidelines have a few main points. The guidelines state that all women should have a risk assessment by age 30 – especially minority women. It also emphasizes the importance of screening in overlooked or underserved populations, including transgender individuals and Black women. The ACR and SBI continue to recommend annual screening beginning at age 40 for women of average risk.
The new guidelines point out that certain factors such as sex assigned at birth, hormone use, and surgical histories place transgender individuals at increased risk for breast cancer, and describe that “due to hormone use, biological males transitioning to female are at increased risk for breast cancer compared to other males.” Further, biological females transitioning to a male who does not undergo mastectomy remain at their previous risk for breast cancer – this is important to note as many transgender individuals are less likely to undergo routine checkups and screening. This is true, too, for many minority women, “said Dr. Emily Conant, one of the authors of the guidelines. Minority women are 72% more likely to be diagnosed with breast cancer before age 50, 58% are more likely to be diagnosed with the advanced-stage disease before 50, and 12% more likely to die from the disease, compared with white women.” Therefore, it is vital that all women undergo a risk assessment by age 30 and start screening at age 40 – delaying screening until 50 will result in unnecessary loss of life to breast cancer, particularly in minority women.
Since the 1980s, when annual screening mammography became widespread, it has been proven to decrease breast cancer mortality by 40%. To maximize the benefits of screening mammography, annual screening should be followed without an upper age limit. Dr. Stamatia Destounis, one of our very own Elizabeth Wende Breast Care (EWBC) physicians, and author of the new guidelines, and the Chief of the ACR Breast Imaging Commission said, “new evidence continues to support annual screening starting at age 40, with closer attention given to minority women in underserved populations…. mounting data and more inclusive screening recommendations should remove any thought that regular screening is controversial.”
Reference: Monticciolo DL, Malak SF, Friedewald SM, Eby PR, Newell MS, Moy L, Destounis S, Leung J, Hendrick RE, Smetherman D. Breast Cancer Screening Recommendations Inclusive of All Women at Average Risk: Update from the ACR and Society of Breast Imaging. J Am Coll Radiol 2021, article in press.