Breast Cancer Screening: The Debate that Never Ends

  • Sarah M. FriedewaldEmail author
Part of the Cancer Treatment and Research book series (CTAR, volume 173)


Screening mammography has been shown to decrease breast cancer deaths through randomized controlled trials. However, there remains significant debate surrounding the most appropriate time to commence screening and the optimal screening interval. Several national organizations have recently updated their guidelines by reanalyzing the published data. Interestingly, each organization has come to different conclusions regarding their recommendation for breast cancer screening in the average risk woman. Three of the main organizations that issue guidelines for breast cancer screening in the United States are reviewd in this chapter.


Screening Mammography Randomized controlled trials Breast imaging 


  1. 1.
    Hendrick RE, Helvie MA (2012) Mammography screening: a new estimate of number needed to screen to prevent one breast cancer death AJR. Am J Roentgenol 198(3):723–728CrossRefGoogle Scholar
  2. 2.
    Miller AB, Wall C, Baines CJ et al (2014) Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ 348:g366CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Tabár L, Fagerberg G, Duffy SW et al (1989) The Swedish Two-County Trial of mammographic screening for breast cancer: recent results and calculation of benefit. J Epidemiol Commun Health 43:107–114CrossRefGoogle Scholar
  4. 4.
    Breast cancer Surveillance Consortium Accessed at on 19 July 2017
  5. 5.
    Kerlikowske K et al (2015) Identifying women with dense breasts at high risk for interval cancer: a cohort study identifying women with dense breasts at high risk for interval cancer. Ann Intern Med 162(10):673–681CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    U. S. Preventive Services Task Force. About the USPSTF. Accessed at on 22 July 2017
  7. 7.
    Bibbins-Domingo K, Whitlock E, Wolff T, et al (2017) Developing recommendations for evidence-based clinical preventive services for diverse populations: methods of the U.S. preventive services task force. Ann Intern Med. 166(8):565–571Google Scholar
  8. 8.
    United States Preventive Services Task Force. grade definitions. Accessed at on 22 July 2017
  9. 9.
    U.S. Preventive Services Task Force (2009), screening for breast cancer: U.S. preventive services task force recommendation statement. Ann Intern Med 151:716–726Google Scholar
  10. 10.
    Mandelblatt JS, Cronin KA, Bailey S et al (2009) Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms. Ann Intern Med 151:738–747CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Kopans DB (2005) Informed Decision Making: Age of 50 is arbitrary and has no demonstrated influence on breast cancer screening in women. AJR 185:176–182Google Scholar
  12. 12.
    Michaelson JS, Satija S, Moore R (2003) Estimates of breast cancer growth rates and sojourn time from screening database information. J Women’s Imaging 5:11–19Google Scholar
  13. 13.
    Michaelson JS, Satija S, Moore R (2003) Estimates of the sizes at which breast cancers become detectable on mammographic and clinical grounds. J Women’s Imaging 5:3–10Google Scholar
  14. 14.
    Zackrisson S, Andersson I, Janzon L, Manjer J, Garne JP (2006) Rate of over-diagnosis of breast cancer 15 years after end of Malmö mammographic screening trial: follow-up study. BMJ 332(7543):689–692CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Tabár L, Fagerberg G, Duffy SW et al (1989) The Swedish Two-County Trial of mammographic screening for breast cancer: Recent results and calculation of benefit. J Epidemiol Community Health 43:107–114CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Welch HG, Black WC Using autopsy series to estimate the disease “reservoir” for ductal carcinoma in situ of the breast: how much more breast cancer can we find? Ann Intern Med 1 Dec 1997 127(11):1023Google Scholar
  17. 17.
    United States Preventive Services Task Force. Breast Cancer: screening Accessed at on 22 July 2017
  18. 18.
    Oeffinger KC, Fontham ET, Etzioni R (2015) Breast cancer screening for women at average risk: 2015 guideline update from the american cancer society. JAMA 314(15):1599–1614CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Howlander N, Noone A, Krapcho M et al SEER Cancer Statistics Review, 1975–2012. Bethesda, MD: National Cancer Institute;, based on November 2014 SEER data submission, posted to the SEER web site, April 2015
  20. 20.
    Smith RA, Saslow D, Sawyer KA et al (2003) American Cancer Society guidelines for breast cancer screening: update 2003. CA Cancer J Clin 53(3):141–169CrossRefPubMedGoogle Scholar
  21. 21.
    National Comprehensive Cancer Network Breast Cancer Screening and Diagnosis (2017) V. 1.2017. Accessed at on 24 July 2017
  22. 22.
    Pisano ED, Gatsonis C, Hendrick E et al (2005) Diagnostic performance of digital versus film mammography for Breast-cancer screening. N Engl J Med 353:1773–1783CrossRefPubMedGoogle Scholar
  23. 23.
    Friedewald SM, Rafferty EA, Rose SL et al (2014) JAMA 311(24):2499–2507CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Northwestern University, Feinberg School of MedicineChicagoUSA

Personalised recommendations