Breast cancer screening

Who to screen: women ages 40-74 at average or moderately increased risk. Do not use this pathway for symptoms, prior breast cancer, known high-risk genetic syndromes, or prior chest radiation.

Test and interval: screening mammography every 2-3 years for ages 40-74 when screening is chosen. Routine screening is not recommended after age 74.

Shared decision: discuss absolute benefit, false positives, and potential overdiagnosis, especially for ages 40-49. Document the patient preference and recall interval.

Additional imaging: do not use MRI or ultrasound as screening tests for women with dense breasts at average or moderately increased risk.