Recommendations from European Breast Guidelines
Should triennial vs. biennial mammography screening be used for early detection of breast cancer in women aged 70 to 74?
- Strong recommendation against the intervention
- Conditional recommendation against the intervention
- Conditional recommendation for either the intervention or the comparison
- ✓ Conditional recommendation for the intervention
- Strong recommendation for the intervention
A recommendation can be strong or conditional.
When a recommendation is strong, most women will want to follow it. When a recommendation is conditional, the majority of women want to follow it but may need more discussion with their healthcare professional first.
As agreement within the GDG for direction of this recommendation could not be reached, voting among the members without CoI resulted in the following: ten members voted in favour of 'conditional recommendation for the intervention' and nine members voted in favour of ‘conditional recommendation for either the intervention or the comparison'.
The reasons for a conditional recommendation are the sustainability of the screening programme, the cost of the intervention and the resources available.
Monitoring and EvaluationNone considered.
EvidenceDownload the evidence profile
No specific studies neither focusing on the rest of the critical outcomes nor comparing different screening intervals were identified. The findings, all from mammography studies, however, are likely to be generalisable to facing the decision of selecting different mammography schedules, as all screening intervals are associated with similar desirable and undesirable effects (e.g. false positive findings or overdiagnosis).
- Ferlay, J., Steliarova-Foucher, E., Lortet-Tieulent, J., Rosso, S., Coebergh, J. W., Comber, H., Forman, D., Bray, F., [Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012] Eur J Cancer; 2013
- Tsilidis, K. K., Papadimitriou, N., Capothanassi, D., Bamia, C., Benetou, V., Jenab, M., Freisling, H., Kee, F., Nelen, A., O'Doherty, M. G., Scott, A., Soerjomataram, I., Tjonneland, A., May, A. M., Ramon Quiros, J., Pettersson-Kymmer, U., Brenner, H., Schottker, B., Ordonez-Mena, J. M., Karina Dieffenbach, A., Eriksson, S., Bogeberg Mathiesen, E., Njolstad, I., Siganos, G., Wilsgaard, T., Boffetta, P., Trichopoulos, D., Trichopoulou, A., [Burden of Cancer in a Large Consortium of Prospective Cohorts in Europe] J Natl Cancer Inst; 2016
- Ferlay, J, [Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer] Available from: https://gco.iarc.fr/today, accessed [03/12/2018].; 2018
- Ferlay, J, Soerjomataram, I , Ervik, M, Dikshit, R , Eser, S , Mathers, C, Rebelo, M, Parkin, DM, Forman, D, Bray, F, [GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide] ; 2013
- Braithwaite, D. Breast Cancer Surveillance, Consortium. (2013). Screening outcomes in older US women undergoing multiple mammograms in community practice: does interval, age, or comorbidity score affect tumour characteristics or false positive rates? J Natl Cancer Inst, 105(5), 334-341.
- Breast Screening Frequency Trial, Group. (2002). The frequency of breast cancer screening: results from the UKCCCR Randomised Trial. United Kingdom Co-ordinating Committee on Cancer Research. Eur J Cancer, 38(11), 1458-1464
- Coldman, A. J., (2008). Impact of changing from annual to biennial mammographic screening on breast cancer outcomes in women aged 50-79 in British Columbia. J Med Screen, 15(4), 182-187
- Dittus K. Impact of mammography screening interval on breast cancer diagnosis by menopausal status and BMI. J Gen Intern Med 28(11):1454–62.
- Duffy, SW. (2008). Long term mortality results from the UK screening frequency trial in 6th European reast Cancer Conference: Berlin, Germany.
- Habbema J.D.F. Age-specific reduction in breast cancer mortality by screening: an analysis of the results of the Health Insurance Plan of Greater New York Study. JNCI 1986; 77:317-320
- Hunt, K. A., Rosen, E. L., & Sickles, E. A. (1999). Outcome analysis for women undergoing annual versus biennial screening mammography: a review of 24,211 examinations. AJR Am J Roentgenol, 173(2), 285-289
- Kerlikowske, K. Breast Cancer Surveillance, Consortium. (2013). Outcomes of screening mammography by frequency, breast density, and postmenopausal hormone therapy. JAMA Intern Med, 173(9), 807-816 Klemi, P. J., Toikkanen, S., Rasanen, O., Parvinen, I., & Joensuu, H. (1997). Mammography screening interval and the frequency of interval cancers in a population-based screening. Br J Cancer, 75(5), 762-766
- Mandelblatt J. Collaborative modeling of the benefits and harms associated with different U.S. breast cancer screening strategies. Ann Intern Med. 2016; 164:215-225.
- Miglioretti D. Breast tumor prognostic characteristics and biennial vs annual mammography, age, and menopausal status. JAMA Oncol. 2015;1(8):1069-1077.
- Miglioretti J. Radiation-induced breast cancer incidence and mortality from digital mammography screening. Ann Intern Med. 2016; 164:205-214. Miller A. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ 2014; 348: g366
- Moss S. Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years´follow-up: a randomised controlled trial. Lancet Oncol 2015; 16 :1123-32
- Nystrom L. Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet 2002; 359: 909-19
- O'Meara, E. (2013). Mammographic screening interval in relation to tumour characteristics and false-positive risk by race/ethnicity and age. Cancer, 119(22), 3959-3967
- Parvinen, I., Chiu, S., Pylkkanen, L., Klemi, P., Immonen-Raiha, P.(2011). Effects of annual vs triennial mammography interval on breast cancer incidence and mortality in ages 40-49 in Finland. Br J Cancer, 105(9), 1388-1391. doi: 10.1038/bjc.2011.372
- Tabar L. The Swedish two-county trial twenty years later. Radiol Clin North Am 2000; 4: 625-51
- Tsunematsu, M., (2015). An analysis of mass screening strategies using a mathematical model: comparison of breast cancer screening in Japan and the United States. J Epidemiol, 25(2), 162-171
- Vilaprinyo, E. Interval Cancer Study, Group. (2014). Cost-effectiveness and harm-benefit analyses of risk-based screening strategies for breast cancer. PLoS One, 9(2), e86858.
- Yaffe, M. . (2011). Risk of radiation-induced breast cancer from mammographic screening. Radiology, 258(1), 98-105
- Yaffe, M. J. (2015). Clinical outcomes of modelling mammography screening strategies. Health Rep, 26(12), 9-15.
JRC Technical Report PICO 10-11, contract FWC443094012015; available upon request.
- Carles M, Vilaprinyo E, Cots F, Gregori A, Pla R, Román R, Sala M, Macià F, Castells X, Rue M. Cost-effectiveness of early detection of breast cancer in Catalonia (Spain). BMC Cancer. 2011 May 23; 11: 192.
- Gocgun Y, Banjevic D, Taghipour S, Montgomery N, Harvey BJ, Jardine AK, Miller AB. Cost-effectiveness of breast cancer screening policies using simulation. Breast. 2015; 24(4): 440-8.
- Rojnik K, Naversnik K, Mateović-Rojnik T, Primiczakelj M. Probabilistic cost-effectiveness modeling of different breast cancer screening policies in Slovenia. Value Health. 2008 Mar-Apr; 11(2): 139-48.
- Vilaprinyo E, Forné C, Carles M, Sala M, Pla R, Castells X, Domingo L, Rue M; Interval Cancer (INCA) Study Group. Cost-effectiveness and harm-benefit analyses of risk-based screening strategies for breast cancer. PLoS One. 2014; 9(2): e86858.
- No systematic review was carried out