Breast Cancer Screening Interval: Risk Level May Matter
Authors: Christine D. Berg
Journal: Annals of Internal Medicine (2016)

Editorials15 November 2016Breast Cancer Screening Interval: Risk Level May MatterChristine D. Berg, MDChristine D. Berg, MDFrom Johns Hopkins Medicine, Bethesda, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1791 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The U.S. Preventive Services Task Force (USPSTF) released an updated final recommendation for breast cancer screening recently, confirming that regular screening mammography is effective in reducing breast cancer mortality for women aged 40 to 74 years (1). For any medical intervention, benefits need to be weighed against harms. As we move toward more personalized medical interventions, tailoring one's recommendation based on individualized risk and individualized harm becomes increasingly important.Randomized clinical trials are considered the gold standard by which we should evaluate medical interventions. However, when estimating a sample size for trials, researchers assume that participants at the outset have ...References1. Siu AL; U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164:279-96. [PMID: 26757170]. doi:10.7326/M15-2886 LinkGoogle Scholar2. Kovalchik SA, Tammemagi M, Berg CD, Caporaso NE, Riley TL, Korch M, et al. Targeting of low-dose CT screening according to the risk of lung-cancer death. N Engl J Med. 2013;369:245-54. [PMID: 23863051] doi:10.1056/NEJMoa1301851 CrossrefMedlineGoogle Scholar3. Pinsky PF, Miller A, Kramer BS, Church T, Reding D, Prorok P, et al. Evidence of a healthy volunteer effect in the prostate, lung, colorectal, and ovarian cancer screening trial. Am J Epidemiol. 2007;165:874-81. [PMID: 17244633] CrossrefMedlineGoogle Scholar4. Trentham-Dietz A, Kerlikowske K, Stout NK, Miglioretti DL, Schechter CB, Ergun MA, et al. Tailoring breast cancer screening intervals by breast density and risk for women aged 50 years or older: collaborative modeling of screening outcomes. Ann Intern Med. 2016;165:700-12. doi:10.7326/M16-0476 LinkGoogle Scholar5. Ravdin PM, Cronin KA, Howlader N, Berg CD, Chlebowski RT, Feuer EJ, et al. The decrease in breast-cancer incidence in 2003 in the United States. N Engl J Med. 2007;356:1670-4. [PMID: 17442911] CrossrefMedlineGoogle Scholar6. Bernardi D, Pellegrini M, DiMichele S, Tuttobene P, Fantò C, Valentini M, et al. Interobserver agreement in breast radiological density attribution according to BI-RADS quantitative classification. Radiol Med. 2012;117:519-28. [PMID: 22228132] doi:10.1007/s11547-011-0777-3 CrossrefMedlineGoogle Scholar7. Oeffinger KC, Fontham ET, Etzioni R, Herzig A, Michaelson JS, Shih YC, et al; American Cancer Society. Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA. 2015;314:1599-614. [PMID: 26501536] doi:10.1001/jama.2015.12783 CrossrefMedlineGoogle Scholar8. Moss SM, Wale C, Smith R, Evans A, Cuckle H, Duffy SW. Effect of mammographic screening from age 40 years on breast cancer mortality in the UK Age trial at 17 years' follow-up: a randomised controlled trial. Lancet Oncol. 2015;16:1123-32. [PMID: 26206144] doi:10.1016/S1470-2045(15)00128-X CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins Medicine, Bethesda, Maryland.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1791.Corresponding Author: Christine D. Berg, MD, Department of Radiation Oncology, The Johns Hopkins Hospital, The Weinberg Building at the Johns Hopkins Kimmel Cancer Center, 401 North Broadway, Baltimore, MD 21231; e-mail, [email protected]com.This article was published at www.annals.org on 23 August 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes Amy Trentham-Dietz , Karla Kerlikowske , Natasha K. Stout , Diana L. Miglioretti , Clyde B. Schechter , Mehmet Ali Ergun , Jeroen J. van den Broek , Oguzhan Alagoz , Brian L. Sprague , Nicolien T. van Ravesteyn , Aimee M. Near , Ronald E. Gangnon , John M. Hampton , Young Chandler , Harry J. de Koning , Jeanne S. Mandelblatt , Anna N.A. Tosteson , and Metrics 15 November 2016Volume 165, Issue 10Page: 737-738KeywordsBiopsyBirthBreast cancerBreast cancer screeningCancer screeningHormonesMagnetic resonance imagingMammographyMedical risk factorsTomosynthesis ePublished: 23 August 2016 Issue Published: 15 November 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...