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Cancer Screening, Diagnosis and Care

European guidelines on breast cancer screening and diagnosis


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3. Screening ages and frequencies

Recommendations

If you are aged 40 to 44, should you attend an organised mammography screening programme?

No, the ECIBC's Guidelines Development Group (GDG) suggests that women between 40 and 44 years old, who are not at high risk of breast cancer and do not have symptoms, should not have mammography screening.

Who are these recommendations for?

  • You are between 40 and 44 years old
  • You do not have a high risk of breast cancer
  • You do not have symptoms of breast cancer

What would following these recommendations mean for you?

You may wish to speak with your healthcare professional to determine if you are at high, average or low risk of breast cancer.

You can also speak with your healthcare professional about how you feel about the balance of benefits and harms, especially:

  • Overdiagnosis leading to overtreatment, including the possibility of having an unnecessary mastectomy
  •  Anxiety and distress
  •  How fearful you feel about breast cancer
  •  How able you are to live with uncertainty

Additional considerations

This recommendation suggests not having breast screening with mammography if you are between 40 and 44 years old, because there are probably greater harms than benefits.

The benefits of screening are small for women between 40 and 44 years. The risk of dying from breast cancer is reduced and there would be little or no effect on your risk of death from other causes. It is uncertain whether mammography screening may reduce your risk of developing breast cancer of stage III or higher.

The research suggests that women who are screened regularly with mammography have a risk of being overdiagnosed.

There is also a small chance of a false positive mammography result, which means that you would have further tests after screening. These tests will confirm that you do not have cancer, but you may have suffered unnecessary anxiety and distress.

Definitions

Overdiagnosis: An overdiagnosed cancer is a cancer diagnosed by screening which is so slow-growing that it would never have been diagnosed in a person’s lifetime if the person had not been screened. We cannot tell which cancers are of this type, however, so, treatment is the same as if it was not overdiagnosed. Therefore, you will be advised to have treatment, possibly including mastectomy (removal of the breast).

yes