Recent controversies over the recommendations for breast cancer screening have created some uncertainty about the best methods of providing this care for women, particularly women at average risk for breast cancer. This article reviews the current recommendations for breast cancer screening from various national organizations and the scientific data behind these recommendations, and it highlights some of the controversies and the reasons behind the differing viewpoints. This article focuses on providing the obstetrician-gynecologist with evidence-based recommendations for counseling and screening women who are at average and high risk for breast cancer. The ability to identify women at higher risk for breast cancer and the appropriate clinical use of mammography, ultrasonography, MRI, clinical breast examination, and self-breast examination (“breast self-awareness”) for breast cancer screening in these different populations are discussed. Finally, incorporating specific recommendations for breast cancer screening in women at average and high risk into practice are included.
Breast cancer screening is a critical component of well-woman care, and applying evidence-based recommendations can reduce breast cancer mortality substantially.
From the University of Michigan Medical School, Department of Obstetrics and Gynecology, Division of Gynecology, Breast Diseases Program, Ann Arbor, Michigan.
Continuing medical education for this article is available at http://links.lww.com/AOG/A209.
Corresponding author: Mark D. Pearlman, MD, University of Michigan Medical School, 1500 E. Medical Center Dr, L4000, Women's Hospital, Ann Arbor, MI 48109-5276; e-mail: Pearlman@med.umich.edu.
Financial Disclosure The authors did not report any potential conflicts of interest.