New ACP Guidelines: Is Your Breast Cancer Screening Up to Date?

ACP Guidelines: Updated Breast Cancer Screening Protocols

Internal medicine physicians often lead preventive care. Therefore, understanding the latest protocols for Breast cancer screening is essential. The American College of Physicians recently updated its guidance for asymptomatic, average-risk females. Furthermore, this update synthesizes high-quality international data to streamline clinical decisions.

Guidance for Ages 40 to 74

For women aged 50 to 74, the ACP recommends biennial mammography. Additionally, this interval balances mortality reduction with potential harms like overdiagnosis. However, for women aged 40 to 49, clinicians should emphasize shared decision-making. Physicians should discuss the individual risk and personal preferences of each patient. Furthermore, harms often outweigh benefits for most women in this younger cohort. If a woman chooses screening, the clinician should follow a biennial schedule.

Improving Outcomes with Breast Cancer Screening

Clinicians must also identify when to stop routine tests. Specifically, for women aged 75 and older, the benefits of screening are less certain. Physicians should discuss discontinuation with patients who have a limited life expectancy. Additionally, the guidance addresses the unique challenges of dense breasts. Clinicians may consider supplemental digital breast tomosynthesis in these cases. Nevertheless, the ACP advises against using MRI or ultrasound for average-risk individuals. Consequently, these recommendations aim to promote high-value care while minimizing patient harm.

Frequently Asked Questions

Q1: At what age should average-risk women start biennial mammography?

According to the 2026 guidance, the ACP recommends routine biennial screening for women between the ages of 50 and 74. For women aged 40 to 49, clinicians should facilitate shared decision-making regarding the benefits and risks of starting earlier.

Q2: Is supplemental imaging like MRI recommended for women with dense breasts?

No, the ACP advises against using supplemental MRI or ultrasound for screening in average-risk individuals. However, clinicians may consider digital breast tomosynthesis (DBT) for patients with dense breasts after discussing potential risks.

Q3: When should a woman stop getting routine screening mammograms?

Clinicians should discuss stopping screening with women aged 75 years or older. This discussion is especially important for patients with a life expectancy of 10 years or less, as harms may outweigh the benefits.

References

1. Qaseem A et al. Screening for Breast Cancer in Asymptomatic, Average-Risk Adult Females: A Guidance Statement From the American College of Physicians (Version 2). Ann Intern Med. 2026 Apr 17. doi: 10.7326/ANNALS-25-05116. PMID: 41996183.
2. US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2024;331(16):1376–1387.
3. World Health Organization. Breast cancer: screening and early diagnosis. 2024.