The American College of Physicians (ACP) has issued new breast cancer screening guidelines recommending biennial mammograms for average-risk, asymptomatic women aged 50 to 74. The guidance, published in the Annals of Internal Medicine, suggests that women aged 40 to 49 discuss risks and benefits with their doctors rather than starting annual screening.
The ACP warns that unnecessary screening can lead to false positives, psychological distress, over-diagnosis, and radiation exposure. For women over 75 with limited life expectancy, the group suggests discussing whether to stop screening.
However, experts like Dr. Lauren Carcas of Miami Cancer Institute criticize the guidance, noting it conflicts with recommendations from the American Society of Breast Surgeons and the American College of Radiology, which call for annual mammograms starting at 40. Carcas argues that biennial screening could widen disparities and delay cancer detection.
The ACP also advises against supplemental MRI or ultrasound for women with dense breasts, recommending only digital breast tomosynthesis (3D mammography). This too faces pushback, as radiologic societies advocate for more comprehensive imaging.
The core disagreement remains the screening interval. While all major U.S. societies agree mammography should be available at 40, they differ on frequency. Dr. Carcas will continue recommending annual screenings and hopes insurance coverage remains unaffected.