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NEW GUIDELINE ALERT: Are you screening for Breast Cancer correctly?


Little has changed; focus is now on shared decision-making

What's new in screening for breast cancer? The guidelines from the Canadian Task Force on Preventive Health Care (CTFPHC) - endorsed by the Canadian Cancer Society - have just changed once again!

SNAP SAMP: These guidelines apply to patients NOT at increased risk of breast cancer. List FOUR criteria that place a patient at increased risk of breast cancer to whom this guideline does NOT apply.

(Answers are below!)

So what has changed in the CTFPHC 2018 Breast Screening Guidelines? Actually, not much. In a nutshell: shared decision-making.

The 2018 recommendations are listed below. Regular text is almost identical to the 2011 guidelines, whereas bold text is NEW for 2018:

  • For women aged 40 to 49 years, we recommend not screening with mammography; the decision to undergo screening is conditional on the relative value a woman places on possible benefits and harms from screening. (Conditional recommendation; low-certainty evidence)

  • For women aged 50 to 69 years, we recommend screening with mammography every two to three years; the decision to undergo screening is conditional on the relative value that a woman places on possible benefits and harms from screening. (Conditional recommendation; very low-certainty evidence)

  • For women aged 70 to 74 years, we recommend screening with mammography every two to three years; the decision to undergo screening is conditional on the relative value that a woman places on possible benefits and harms from screening. (Conditional recommendation; very low-certainty evidence)

As you can see, the main recommendations have hardly changed from 2011!

Useful tools to help with shared decision-making

Fortunately the CTFPHC has provided some useful tools such as the 1000-person tool to help see risks and benefits of screening (PDF) to help with shared decision-making.

What about MRI and breast exams?

The guideline also recommends AGAINST screening with

  • MRI

  • Clinical Breast Exam

  • Patient Breast Self-Examination

Answer to SNAP SAMP: Who does the guideline apply to?

This guideline applies only to patients who NOT at increased risk of breast cancer. Therefore, it does not apply to patients with:

  • Personal history of breast cancer

  • Family history of breast cancer

  • Women who are carriers of BRCA1 or BRCA2 gene mutations, or have a first-degree relative with these

  • Women with chest radiation BEFORE age 30 or WITHIN the last 8 years

Other guideline updates in 2018

If you want to find out about more guideline changes for 2018, check out our blog posts on the 2018 Canadian Diabetes Association Guidelines.


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