This statement summarizes the current U.S. Preventive Services Task Force (USPSTF) recommendations on screening for breast cancer and the supporting scientific evidence, and it updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, second edition.¹ Explanations of the ratings and of the strength of overall evidence are given in Appendix A and Appendix B respectively.

The complete information on which this statement is based, including evidence tables and references, will be available in the article, "Breast Cancer Screening with Mammography: Summary of the Evidence"² and in the Systematic Evidence Review on this topic,³ prepared for the U.S. Preventive Services Task Force by the AHRQ-supported Evidence-based Practice Center at Oregon Health & Science University. These documents are currently undergoing final revision and will soon be accessible at the USPSTF Web site (http://www.ahrq.gov/clinic/uspstfix.htm), through the National Guideline Clearinghouse^TM, or in print through the AHRQ Publications Clearinghouse (1-800-358-9295).

To update their recommendations on screening for breast cancer, the USPSTF reviewed the evidence regarding the effectiveness of mammography, clinical breast examination, and breast self-examination in reducing breast cancer mortality. The USPSTF did not review the evidence regarding genetic screening, surveillance of women with prior breast cancer, or formal evaluation of new screening modalities that have not been studied in the general population. A meta-analysis using a Bayesian random effects model was conducted for the USPSTF to obtain a summary of relative risk estimates of the effectiveness of screening with mammography, either alone or in combination with clinical breast examination, in reducing breast cancer mortality. Clinical studies that evaluated breast self-examination were included in the review. Sources for estimates cited in this Recommendation and Rationale statement are described in the Systematic Evidence Review on this topic (forthcoming).