ACP, ACS issue mammography guidelines

NEWS IN BRIEF — Posted April 16, 2007

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Women at high risk of breast cancer should receive screening with magnetic resonance imaging in addition to mammography, according to American Cancer Society guidelines published in the March/April issue of CA: A Cancer Journal for Clinicians. Also, guidelines from the American College of Physicians in the April 2 Annals of Internal Medicine, said women in their 40s periodically should have their breast cancer risk assessed to guide their decisions about whether to have mammography.

These are the latest attempts to refine breast cancer screening.

The ACS document is in response to several studies, including one in the March 29 New England Journal of Medicine, finding that an MRI can detect cancers missed by mammography and clinical exams. The ACS wants women who have a 20% to 25% lifetime risk of developing this disease, such as those with a family history and those treated for Hodgkin's disease, to receive this screening.

The ACP, in addition to calling for risk assessment in those ages 40 to 49 before mammography, wants women to be informed of the potential harms and benefits of this procedure and additional research into its effect in this age group.

"It is important to tailor the decision of screening mammography by discussing the benefits and risks with a woman, addressing her concerns, and making it a joint decision," said Amir Qaseem, MD, PhD, MHA, lead author and senior medical associate in ACP's medical education and publishing division.

Note: This item originally appeared at

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