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J Am Coll Radiol. 2017 Nov;14(11S):S383-S390. doi: 10.1016/j.jacr.2017.08.044.

ACR Appropriateness Criteria® Breast Cancer Screening.

Author information

1
Principal Author, Alpert Medical School of Brown University, Providence, Rhode Island. Electronic address: mmainiero@lifespan.org.
2
Panel Vice Chair, NYU Clinical Cancer Center, New York, New York.
3
Roper St. Francis Physician Partners Breast Surgery, Charleston, South Carolina; American College of Surgeons.
4
Northwestern University Feinberg School of Medicine, Chicago, Illinois; American College of Physicians.
5
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
6
The University of Mississippi Medical Center, Jackson, Mississippi.
7
New York University School of Medicine, New York, New York.
8
Emory University Hospital, Atlanta, Georgia.
9
University of Cincinnati Medical Center, Cincinnati, Ohio.
10
Alpert Medical School of Brown University, Providence, Rhode Island.
11
Wellessence MD, Schaumburg, Illinois; American College of Physicians.
12
H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
13
Beth Israel Deaconess Medical Center, Boston, Massachusetts.
14
Women and Infants Hospital, Providence, Rhode Island; American Congress of Obstetricians and Gynecologists.
15
Hofstra Northwell School of Medicine, Manhasset, New York.
16
Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.
17
University of Miami, Miami, Florida.
18
Panel Chair, Emory University Hospital, Atlanta, Georgia.

Abstract

Breast cancer screening recommendations are based on risk factors. For average-risk women, screening mammography and/or digital breast tomosynthesis is recommended beginning at age 40. Ultrasound (US) may be useful as an adjunct to mammography for incremental cancer detection in women with dense breasts, but the balance between increased cancer detection and the increased risk of a false-positive examination should be considered in the decision. For intermediate-risk women, US or MRI may be indicated as an adjunct to mammography depending upon specific risk factors. For women at high risk due to prior mantle radiation between the ages of 10 to 30, mammography is recommended starting 8 years after radiation therapy but not before age 25. For women with a genetic predisposition, annual screening mammography is recommended beginning 10 years earlier than the affected relative at the time of diagnosis but not before age 30. Annual screening MRI is recommended in high-risk women as an adjunct to mammography. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

KEYWORDS:

AUC; Appropriate Use Criteria; Appropriateness Criteria; Breast Cancer; Breast MRI; Breast US; Mammography; Screening

PMID:
29101979
DOI:
10.1016/j.jacr.2017.08.044
[Indexed for MEDLINE]

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