VIDEO: Guideline revisions dramatically change approaches to breast cancer screening

WASHINGTON – Clinicians should consider a woman’s overall risk for developing breast cancer when establishing screening protocols, said Melissa McNeil, MD, MPH, MACP, Chief of the Section on Women’s Health at the University of Pittsburgh Medical Center, at the American College of Physicians Internal Medicine Meeting.

The American Cancer Society (ACS)’s updated screening guidelines recommend assessing a woman’s overall risk and establish her as being at low, average, or high risk for developing breast cancer. For a woman at average risk, the recommendation is to begin screening at age 45, to screen yearly until 55, then every other year until the patient’s life expectancy is less than 10 years. The ACS has also recommended against clinical breast examination in the office.

These recommendations have “turned the screening guidelines on their head” but are “rationale” and women in McNeil’s practice have been “most receptive to them,” she said.

Although 24 states recommend supplemental screening mammograms in women with increased breast density, a paper published this year reported that breast density alone did not significantly increase risk of breast cancer within a year of a mammogram, and the woman’s overall risk should be assessed, McNeil said.

In other research related to women’s health, no benefit has been found from the use of calcium supplements or vitamin D in terms of fracture risk, McNeil said. Clinicians should advocate prevention of osteoporosis through healthy living, good weight bearing exercise and dietary calcium, she added.