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Screening for breast cancer: Strategies and recommendations

Joann G Elmore, MD, MPH
Section Editor
Mark D Aronson, MD
Deputy Editor
Judith A Melin, MA, MD, FACP


Breast cancer is the most frequent type of non-skin cancer and the most frequent cause of cancer death in women worldwide, and the second most frequent cause of cancer death in United States women. (See "Clinical features, diagnosis, and staging of newly diagnosed breast cancer", section on 'Introduction' and "Clinical features, diagnosis, and staging of newly diagnosed breast cancer", section on 'Epidemiology' and "Diagnostic evaluation of women with suspected breast cancer", section on 'Introduction'.)

The majority of breast cancers in the United States are diagnosed as a result of an abnormal screening study, although a significant number are first brought to attention by a patient. Findings suggest that screening mammography both reduces the odds of dying of breast cancer and facilitates the use of early treatment. While the odds of dying of metastatic breast cancer are roughly one-third of what they were in the 1980s, it is thought that improvements in breast cancer treatment are more likely responsible for this reduction in mortality than screening [1-4].

Recommendations for breast cancer screening, taking into account the risk of developing breast cancer, other parameters that might affect screening decisions, and benefits and harms of screening, are discussed here.

Identification and management of women with a genetic predisposition to breast cancer, and surveillance in women with a personal history of breast cancer, are discussed in detail separately. (See "Genetic counseling and testing for hereditary breast and ovarian cancer" and "Management of patients at high risk for breast and ovarian cancer" and "Approach to the patient following treatment for breast cancer".)

The evidence for the effectiveness and harms of screening for breast cancer in women, and performance characteristics of mammography, are discussed in detail separately. (See "Screening for breast cancer: Evidence for effectiveness and harms" and "Breast imaging for cancer screening: Mammography and ultrasonography".)


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