ACR statement on final USPSTF breast cancer screening recommendations

The final United States Preventive Services Task Force (USPSTF) Breast Cancer Screening Recommendations, while an improvement over previous guidance, do not go far enough to save more women’s lives.

The American College of Radiology® (ACR®) will continue to urge the USPSTF to recommend all women have a breast cancer risk assessment by age 25 (as called for in ACR’s Breast Cancer Screening guidelines for high-risk women) and that women at average risk for breast cancer receive an annual mammography screening starting at age 40. Women at higher risk for breast cancer should talk to their doctor about starting screening prior to age 40 and additional screening methods.

The USPSTF, American College of Radiology, American Cancer Society, Society of Breast Imaging and others all agree that the most lives are saved with this annual approach. The ACR and SBI maintain their commitment to promote the value of annual screenings with mammography as stated in their joint average-risk guidelines. Medical experts must clear the confusion caused by differing recommendations.

Mounting evidence shows that Black and other minority women, (Ashkenazi) Jewish women, and others develop and die from breast cancer prior to age 50 — or even age 40 — more often than non-Hispanic white women. As our 2021 guidelines for average-risk women and our 2023 guidelines for high-risk women make clear, potentially giving cancer another year to advance may particularly impact these women.

Involving factors such as sex assigned at birth, hormone use and surgical history place transgender persons at increased risk for breast cancer. Biological females transitioning to male who do not undergo mastectomy remain at their previous risk for breast cancer and should continue to be screened as such.

As outlined in current (2021) ACR/SBI recommendations for average-risk women, due to hormone use, biological males transitioning to female are at increased risk for breast cancer compared to other males and should speak with their doctor about their breast cancer risk.

ACR and SBI also recommend that women continue screening past age 74, unless severe comorbidities limit life expectancy.