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Breast surgeons society issues new screening mammography guidelines


Women at average risk of breast cancer should begin annual screening mammograms at age 40, a leading breast surgeons group recommends. Women at higher risk of breast cancer, including those with a family history of the disease, should be screened annually once they are identified as having higher risk.

Additionally, breast tomosynthesis, or 3D mammography, is the preferred form of breast cancer screening with imaging, when it’s available, according to The American Society of Breast Surgeons.

The guidelines are part of a position paper written by Julie Margenthaler, MD, and colleagues at the breast surgeons society. Margenthaler is the group’s president-elect and a Washington University surgeon at Siteman Cancer Center, based at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis. The society approved the recommendations at its 2019 annual meeting.

“Our guidelines are unique in that they incorporate risk assessment for all women in order to personalize the mammography surveillance approach,” Margenthaler said.

Previously, the society advised women at average risk to begin screening at age 45, with potential screening beginning at age 40 a matter of “shared decision-making” between a woman and her physician.

The new guidelines lower the age of initial screening for women at average risk in order to:

  • Simplify the criteria for beginning screening at age 40.
  • Acknowledge the growing number of women in their 40s who face these decisions.
  • Address the higher instances of advanced breast cancer diagnoses in younger African American women, compared to white American women.

“Although the extent to which screening mammography can reverse outcome disparities is unclear, the benefits of early detection through screening are compelling arguments in favor of mammography screening as a valuable weapon in achieving health equity,” Margenthaler said.

The society, founded in 1995, is the primary leadership organization for general surgeons who treat patients with breast disease. The group works to promote education, research and the development of advanced surgical techniques.

Margenthaler will serve as president-elect until she becomes president of the society in 2020. She previously served as secretary-treasurer.