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ACR and SBI Call for Significant Changes to Breast Cancer Screening Process

New ACR and Society of Breast Imaging (SBI) breast cancer screening guidelines are the first to recognize that African-American women are at high risk of the disease and should be screened as such. The ACR and SBI now call for all women to have a risk assessment at age 30 to see whether screening earlier than age 40 is needed. The societies also newly recommend that women previously diagnosed with breast cancer be screened with MRI. The ACR and SBI continue to recommend that women at average breast cancer risk begin screening at age 40.

"The latest scientific evidence overwhelmingly supports a continued general recommendation of starting annual screening at age 40. It also supports augmented and earlier screening for many women. These updates will help save more lives," says Debra Monticciolo, MD, FACR, chair of the ACR Breast Imaging Commission.

According to 2015 National Cancer Institute Surveillance, Epidemiology, and End Results data, since mammography became widespread in the 1980s, the US breast cancer death rate in women, unchanged for the previous 50 years, has dropped 43%. Breast cancer deaths in men, who have the same treatment as women but are not screened, have not declined.

Factors that contributed to the ACR/SBI reclassification of African-American women include: 

• African-American women are 42% more likely to die from breast cancer than non-Hispanic white women, despite roughly equal incidence rates;
• African-American women have a twofold higher risk of aggressive—"triple-negative"—breast tumors;
• African-American women are less likely to be diagnosed with stage 1 breast cancer but twice as likely to die of early breast cancers; and
• African-American women have a higher risk of BRCA1 and BRCA2 genetic mutations than women of Western European ancestry. These carriers are at much higher risk for breast cancer.

"Since 1990, breast cancer death rates dropped 23% in African-American women—approximately half that in whites. We changed our approach to help save more African-American women and others at higher risk from this deadly disease," says Wendy B. DeMartini, MD, FSBI.

For more information regarding the proven effectiveness of regular mammography screening in reducing breast cancer deaths, please visit RadiologyInfo.org, MammographySavesLives.org, and EndTheConfusion.org.