European guidelines on breast cancer screening 2020

Reference

Schunemann HJ, Lerda D, Quinn C, et al, for the European Commission Initiative on Breast Cancer (ECIBC) Contributor Group. Breast cancer screening and diagnosis: a synopsis of the European breast guidelines. Ann Intern Med 2020;172(1):46-56.

Synopsis

These guidelines update the European Guidelines on Breast Cancer Screening and Diagnosis, last published in 2006 by the European Commission Initiative on Breast Cancer. The guidelines are based on systematic reviews of the literature and each recommendation is linked back to the supporting evidence. The guideline development group comprised radiologists, policy developers, researchers, and pathologists. The group included a methodologist but not a patient representative. Several of the group members, but not the chair, had financial, intellectual, or professional conflicts of interest. Based on moderate certainty of evidence, the group suggests beginning screening for breast cancer with digital mammography at age 45 years, repeating every 2 or 3 years until age 50 and then continuing every 2 years until age 70, followed by every 3 years until age 75, at which time screening should be stopped. They recommend against using 3-D mammography (digital breast tomosynthesis) for initial screening or for follow-up of a negative digital mammogram result, reserving it for follow-up of suspicious lesions. They do not see a role for magnetic resonance imaging or automated or handheld ultrasound. Except for a strong recommendation that women between the ages of 50 and 70 years should be screened, all the other recommendations are "conditional," meaning that there is considerable room for discussion with women about the possible benefits, risks, and burdens associated with each decision.