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JAMA Insights
Clinical Update
May 1, 2018

Breast Cancer Screening in 2018: Time for Shared Decision Making

Author Affiliations
  • 1Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
  • 2Division of General Internal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
  • 3Division of Women’s Health, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA. 2018;319(17):1814-1815. doi:10.1001/jama.2018.3388

In the past 9 years, there has been a major shift in the recommendations for breast cancer screening. Recognizing additional evidence about the harms of mammography, in 2009, the United States Preventive Services Task Force (USPSTF) revised its previous recommendation of annual mammograms for all women beginning at age 40 years and instead recommended biennial mammograms for women aged 50 to 74 years. The USPSTF recommended against routine screening mammography for women aged 40 to 49 years, stating that the decision to start regular mammography before age 50 years should be an individual one that considers how each patient values specific benefits and harms. The USPSTF reiterated this recommendation in a 2016 update, and other organizations, notably the American Cancer Society in 2015, have joined the USPSTF in recommending less routine use of mammography and a more individualized approach to screening.