Book Navigation

Screening for Breast Cancer: An Update for the U.S. Preventive Services Task Force

Overview
Title:
Screening for Breast Cancer: An Update for the U.S. Preventive Services Task Force
Authors:
Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK, Humphrey L
Journal:
Ann Intern Med
Publication date:
2009
Volume:
151
First page:
727
Last page:
737
Publication type:
Journal
Abstract
Background: This systematic review is an update of evidence since the 2002 U.S. Preventive Services Task Force recommendation on breast cancer screening. Purpose: To determine the effectiveness of mammography screening in decreasing breast cancer mortality among average-risk women aged 40 to 49 years and 70 years or older, the effectiveness of clinical breast examination and breast self-examination, and the harms of screening. Data Sources: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the fourth quarter of 2008), MEDLINE (January 2001 to December 2008), reference lists, and Web of Science searches for published studies and Breast Cancer Surveillance Consortium for screening mammography data. Study Selection: Randomized, controlled trials with breast cancer mortality outcomes for screening effectiveness, and studies of various designs and multiple data sources for harms. Data Extraction: Relevant data were abstracted, and study quality was rated by using established criteria. Data Synthesis: Mammography screening reduces breast cancer mortality by 15% for women aged 39 to 49 years (relative risk, 0.85 [95% credible interval, 0.75 to 0.96]; 8 trials). Data are lacking for women aged 70 years or older. Radiation exposure from mammography is low. Patient adverse experiences are common and transient and do not affect screening practices. Estimates of overdiagnosis vary from 1% to 10%. Younger women have more false-positive mammography results and additional imaging but fewer biopsies than older women. Trials of clinical breast examination are ongoing; trials for breast self-examination showed no reductions in mortality but increases in benign biopsy results. Limitation: Studies of older women, digital mammography, and magnetic resonance imaging are lacking. Conclusion: Mammography screening reduces breast cancer mortality for women aged 39 to 69 years; data are insufficient for older women. False-positive mammography results and additional imaging are common. No benefit has been shown for clinical breast examination or breast self-examination.
Preview

Screening for Breast Cancer: An Update for the U.S. Preventive Services Task Force Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK, Humphrey L. Ann Intern Med 2009; 151:727-737.

Page last updated: Oct 14, 2010
Copyright © 2002-2016 Guidelines International Network.
All rights reserved

The Guidelines International Network is formally constituted as a Scottish Guarantee Company under Company Number SC243691 and recognised as a Scottish Charity under Scottish Charity Number SC034047 with its Registered Office at J. & H. Mitchell W.S., 51 Atholl Road, Pitlochry, Perthshire PH16 5BU, Scotland.

Back to top