Breast Cancer Screening Guidelines

CISNET Provides Support for Development of Breast Cancer Screening Guidelines

The CISNET Breast Working group was commissioned by the U.S. Preventive Services Task Force (USPSTF) in 2009 and 2014 to conduct analyses to inform an update of their breast cancer screening recommendations. In the initial analysis done for the 2009 recommendations, all six models concluded that biennial screening from ages 50-74 was more efficient than earlier starting ages or annual intervals (Mandelblatt et al., 2009). This finding was influential in the Task Force’s choice to recommend biennial plain-film mammography from ages 50 to 74 (USPSTF, 2009).

In the most recent analysis to inform the 2016 USPSTF breast cancer screening recommendations, we used the six models to synthesize current data and examine the outcomes of digital mammography screening at various starting ages and intervals among average-risk women. We also examined how breast density, risk, or comorbidity levels affect results and whether preferences for health states related to screening and its downstream consequences affected conclusions. This modeling study estimated outcomes of eight strategies that differed by starting age and interval (Mandelblatt et al., 2016). As in the earlier analysis, biennial strategies were consistently the most efficient for average-risk women and were influential in informing the 2016 USPSTF screening recommendations (Siu and the USPSTF, 2016).

Results of these studies were published in the following articles in the Annals of Internal Medicine in 2009 and 2016:

Mandelblatt JS, Stout NK, Schechter CB, van den Broek JJ, Miglioretti DL, Krapcho M, et al. Collaborative Modeling of the Benefits and Harms Associated With Different U.S. Breast Cancer Screening Strategies. Ann Intern Med. 2016 Feb 16;164(4):215-25. [Abstract]

Technical Report: Mandelblatt JS, Cronin K, de Koning H, Miglioretti DL, Schechter C, Stout N. Modeling Report: Collaborative Modeling of U.S. Breast Cancer Screening Strategies. AHRQ publication no. 14-05201-EF-4.
Rockville, MD: U.S. Preventive Services Task Force; 2015.
https://www.uspreventiveservicestaskforce.org/uspstf/document/modeling-report-collaborative-modeling-of-us-breast-cancer-1/breast-cancer-screening

Mandelblatt JS, Cronin KA, Bailey S, Berry DA, de Koning HJ, Draisma G, et al. Breast Cancer Working Group of the Cancer Intervention and Surveillance Modeling Network. Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms. Ann Intern Med. 2009;151:738-47. [Abstract] ]