Compared to women who undergo breast cancer screening with mammography alone, those receiving MRI exams experience a two- to fivefold increased rate of core and surgical biopsy. However, the biopsies have a lower cancer yield rate than mammography alone.
The decision to undergo screening mammography requires a consideration of benefits and harms. Harms include false-positive exams leading to unnecessary interventions, and true-positive exams that lead to overdiagnosis.
The U.S. Preventive Services Task Force has issued new guidance on breast cancer screening and called for mammography every two years for women ages 50-74. For women ages 40-49, the Task Force recommends informed, individualized decision-making based on a woman’s values, preferences, and health history.
The U.S. Preventive Services Task Force recently released updates to the 2009 recommendations on breast cancer screening. Additional studies published since the last review strengthen the conclusion that mammography screening results in a reduction in the risk of death from breast cancer.
A new study reports that the incidence of breast cancer is higher in counties with high rates of mammography screening, but screening is not associated with a decrease in breast-cancer deaths. The decision of whether and how often to perform mammography requires a discussion of the potential consequences of both true positive and false positive screening tests.