Breast cancer screening in the United States was first recommended to women in 1976. Over the past decade, mammography screening has changed from film screen mammography to primarily digital mammography, which, as of 2016, accounts for over 97% of all mammograms performed in the United States. Several systematic reviews, which have included results from up to 9 randomized clinical trials from the United States, Europe, and Canada, have demonstrated a reduced risk of breast cancer mortality associated with breast cancer screening. Potential harms from breast cancer screening include false-positive mammograms (which may lead to unnecessary additional imaging and benign breast biopsies), overdiagnosis, and radiation exposure. This chapter summarizes evidence from randomized controlled trials for mortality benefit; current society and task force recommendations for mammography screening; evaluation of the evidence; risk–benefit analysis; and supplemental screening in high-risk women.
Mammography rates after the 2009 revision to the United States Preventive Services Task Force breast cancer screening recommendation