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Personalized Breast Cancer Screening: Moving Beyond Age-Based Algorithms
Breast cancer screening has traditionally been organized around two principal variables: when mammography should begin and how frequently it should be performed.
The USPSTF recommends biennial mammography for average-risk women aged 40 to 74 years, whereas the American College of Radiology recommends annual mammography from age 40 and risk assessment by age 25
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Breast density is associated with increased cancer risk and reduced mammographic sensitivity, but the USPSTF finds insufficient evidence to recommend for or against supplemental MRI or ultrasonography
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Family history, inherited susceptibility, and previous breast findings can alter risk assessment and prompt consideration of genetic counseling, supplemental imaging, or specialist referral.
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For certain high-risk women, the American Cancer Society recommends annual MRI in addition to mammography, generally beginning at approximately age 30.
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After diagnosis, radiation and systemic therapy decisions can be individualized by disease stage, nodal status, tumor biology, and patient-specific factors; selected patients may receive less treatmen
