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Screening Intervals: Annual vs. Biennial
Amy M. Fowler, MD, PhD
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KEY FACTS

  • Imaging

    • Clinical Issues

      TERMINOLOGY

      • Abbreviations

        • National Mammography Database (NMD)
        • Breast Cancer Surveillance Consortium (BCSC)
        • American College of Radiology (ACR)
        • Cancer Intervention Surveillance Modeling Network (CISNET)
        • Digital breast tomosynthesis (DBT)
        • Odds ratio (OR)
      • Definitions

        • Overdiagnosis: Screen detection of cancers that would not have become clinically apparent during patient's lifetime
        • Sojourn time: Time between cancer development and clinical presentation of physical signs or symptoms of disease
        • Lead time: Time between cancer detection by imaging screening vs. when it would have been detected clinically
        • Interval cancer: Cancer diagnosed because of symptoms during interval between recommended screening exams
          • e.g., within 1 year of screening in USA, or within 2 years in Europe, 3 in United Kingdom
        • Recall rate: Percent of screening exams recommended for additional imaging (i.e., BI-RADS 0 assessment)

      IMAGING

      • Imaging Recommendations

        CLINICAL ISSUES

        • Demographics

          • Natural History & Prognosis

            • Treatment

              Selected References

              1. Ahn S et al: Impact of screening mammography on treatment in women diagnosed with breast cancer. Ann Surg Oncol. 25(10):2979-2986, 2018
              2. Carter KJ et al: Insights into breast cancer screening: a computer simulation of two contemporary screening strategies. AJR Am J Roentgenol. 210(3):564-571, 2018
              3. Destounis S et al: Age to begin and intervals for breast cancer screening: balancing benefits and harms. AJR Am J Roentgenol. 210(2):279-284, 2018
              4. Lee CS et al: Harmonizing breast cancer screening recommendations: metrics and accountability. AJR Am J Roentgenol. 210(2):241-245, 2018
              5. Narayan AK et al: Quantifying performance thresholds for recommending screening mammography: a revealed preference analysis of USPSTF guidelines. Breast Cancer Res Treat. 172(2):463-468, 2018
              6. Patel SB: Estimated mortality of breast cancer patients based on stage at diagnosis and national screening guideline categorization. J Am Coll Radiol. 15(9):1206-1213, 2018
              7. Arleo EK et al: Comparison of recommendations for screening mammography using CISNET models. Cancer. 123(19):3673-3680, 2017
              8. Arleo EK et al: Persistent untreated screening-detected breast cancer: an argument against delaying screening or increasing the interval between screenings. J Am Coll Radiol. 14(7):863-867, 2017
              9. Eby PR: Evidence to support screening women annually. Radiol Clin North Am. 55(3):441-456, 2017
              10. Monticciolo DL et al: Breast cancer screening for average-risk women: recommendations from the ACR commission on breast imaging. J Am Coll Radiol. 14(9):1137-1143, 2017
              11. Mandelblatt JS et al: Collaborative modeling of the benefits and harms associated with different U.S. breast cancer screening strategies. Ann Intern Med. 164(4):215-25, 2016
              12. Miglioretti DL et al: Radiation-induced breast cancer incidence and mortality from digital mammography screening: a modeling study. Ann Intern Med. 164(4):205-14, 2016
              13. Nelson HD et al: Harms of breast cancer screening: systematic review to update the 2009 U.S. preventive services task force recommendation. Ann Intern Med. 164(4):256-67, 2016
              14. Siu AL et al: Screening for breast cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 164(4):279-96, 2016
              15. Engel JM et al: All-cause mortality is decreased in women undergoing annual mammography before breast cancer diagnosis. AJR Am J Roentgenol. 204(4):898-902, 2015
              16. Miglioretti DL et al: Breast tumor prognostic characteristics and biennial vs annual mammography, age, and menopausal status. JAMA Oncol. 1(8):1069-77, 2015
              17. Oeffinger KC et al: Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA. 314(15):1599-614, 2015
              18. Sanderson M et al: Mammography screening among the elderly: a research challenge. Am J Med. 128(12):1362.e7-14, 2015
              19. Winch CJ et al: Toward the breast screening balance sheet: cumulative risk of false positives for annual versus biennial mammograms commencing at age 40 or 50. Breast Cancer Res Treat. 149(1):211-21, 2015
              20. Yaffe MJ et al: Clinical outcomes of modelling mammography screening strategies. Health Rep. 26(12):9-15, 2015
              21. Webb ML et al: A failure analysis of invasive breast cancer: most deaths from disease occur in women not regularly screened. Cancer. 120(18):2839-46, 2014
              22. Kerlikowske K et al: Outcomes of screening mammography by frequency, breast density, and postmenopausal hormone therapy. JAMA Intern Med. 173(9):807-16, 2013
              23. O'Meara ES et al: Mammographic screening interval in relation to tumor characteristics and false-positive risk by race/ethnicity and age. Cancer. 119(22):3959-67, 2013
              24. Hendrick RE et al: United States Preventive Services Task Force screening mammography recommendations: science ignored. AJR Am J Roentgenol. 196(2):W112-6, 2011
              25. Wu JC et al: Estimation of natural history parameters of breast cancer based on non-randomized organized screening data: subsidiary analysis of effects of inter-screening interval, sensitivity, and attendance rate on reduction of advanced cancer. Breast Cancer Res Treat. 122(2):553-66, 2010
              26. Mandelblatt JS et al: Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms. Ann Intern Med. 151(10):738-47, 2009
              27. Randall D et al: Annual or biennial mammography screening for women at a higher risk with a family history of breast cancer: prognostic indicators of screen-detected cancers in New South Wales, Australia. Cancer Causes Control. 20(5):559-66, 2009
              28. White E et al: Biennial versus annual mammography and the risk of late-stage breast cancer. J Natl Cancer Inst. 96(24):1832-9, 2004
              29. Carlson KL et al: Relationship between mammographic screening intervals and size and histology of ductal carcinoma in situ. AJR Am J Roentgenol. 172(2):313-7, 1999
              30. Hunt KA et al: Outcome analysis for women undergoing annual versus biennial screening mammography: a review of 24,211 examinations. AJR Am J Roentgenol. 173(2):285-9, 1999
              31. Michaelson JS et al: Breast cancer: computer simulation method for estimating optimal intervals for screening. Radiology. 212(2):551-60, 1999
              32. Feig SA et al: Radiation risk from screening mammography of women aged 40-49 years. J Natl Cancer Inst Monogr. 119-24, 1997
              33. Moskowitz M: Breast cancer: age-specific growth rates and screening strategies. Radiology. 161(1):37-41, 1986
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              References
              Tables

              Tables

              KEY FACTS

              • Imaging

                • Clinical Issues

                  TERMINOLOGY

                  • Abbreviations

                    • National Mammography Database (NMD)
                    • Breast Cancer Surveillance Consortium (BCSC)
                    • American College of Radiology (ACR)
                    • Cancer Intervention Surveillance Modeling Network (CISNET)
                    • Digital breast tomosynthesis (DBT)
                    • Odds ratio (OR)
                  • Definitions

                    • Overdiagnosis: Screen detection of cancers that would not have become clinically apparent during patient's lifetime
                    • Sojourn time: Time between cancer development and clinical presentation of physical signs or symptoms of disease
                    • Lead time: Time between cancer detection by imaging screening vs. when it would have been detected clinically
                    • Interval cancer: Cancer diagnosed because of symptoms during interval between recommended screening exams
                      • e.g., within 1 year of screening in USA, or within 2 years in Europe, 3 in United Kingdom
                    • Recall rate: Percent of screening exams recommended for additional imaging (i.e., BI-RADS 0 assessment)

                  IMAGING

                  • Imaging Recommendations

                    CLINICAL ISSUES

                    • Demographics

                      • Natural History & Prognosis

                        • Treatment

                          Selected References

                          1. Ahn S et al: Impact of screening mammography on treatment in women diagnosed with breast cancer. Ann Surg Oncol. 25(10):2979-2986, 2018
                          2. Carter KJ et al: Insights into breast cancer screening: a computer simulation of two contemporary screening strategies. AJR Am J Roentgenol. 210(3):564-571, 2018
                          3. Destounis S et al: Age to begin and intervals for breast cancer screening: balancing benefits and harms. AJR Am J Roentgenol. 210(2):279-284, 2018
                          4. Lee CS et al: Harmonizing breast cancer screening recommendations: metrics and accountability. AJR Am J Roentgenol. 210(2):241-245, 2018
                          5. Narayan AK et al: Quantifying performance thresholds for recommending screening mammography: a revealed preference analysis of USPSTF guidelines. Breast Cancer Res Treat. 172(2):463-468, 2018
                          6. Patel SB: Estimated mortality of breast cancer patients based on stage at diagnosis and national screening guideline categorization. J Am Coll Radiol. 15(9):1206-1213, 2018
                          7. Arleo EK et al: Comparison of recommendations for screening mammography using CISNET models. Cancer. 123(19):3673-3680, 2017
                          8. Arleo EK et al: Persistent untreated screening-detected breast cancer: an argument against delaying screening or increasing the interval between screenings. J Am Coll Radiol. 14(7):863-867, 2017
                          9. Eby PR: Evidence to support screening women annually. Radiol Clin North Am. 55(3):441-456, 2017
                          10. Monticciolo DL et al: Breast cancer screening for average-risk women: recommendations from the ACR commission on breast imaging. J Am Coll Radiol. 14(9):1137-1143, 2017
                          11. Mandelblatt JS et al: Collaborative modeling of the benefits and harms associated with different U.S. breast cancer screening strategies. Ann Intern Med. 164(4):215-25, 2016
                          12. Miglioretti DL et al: Radiation-induced breast cancer incidence and mortality from digital mammography screening: a modeling study. Ann Intern Med. 164(4):205-14, 2016
                          13. Nelson HD et al: Harms of breast cancer screening: systematic review to update the 2009 U.S. preventive services task force recommendation. Ann Intern Med. 164(4):256-67, 2016
                          14. Siu AL et al: Screening for breast cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 164(4):279-96, 2016
                          15. Engel JM et al: All-cause mortality is decreased in women undergoing annual mammography before breast cancer diagnosis. AJR Am J Roentgenol. 204(4):898-902, 2015
                          16. Miglioretti DL et al: Breast tumor prognostic characteristics and biennial vs annual mammography, age, and menopausal status. JAMA Oncol. 1(8):1069-77, 2015
                          17. Oeffinger KC et al: Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA. 314(15):1599-614, 2015
                          18. Sanderson M et al: Mammography screening among the elderly: a research challenge. Am J Med. 128(12):1362.e7-14, 2015
                          19. Winch CJ et al: Toward the breast screening balance sheet: cumulative risk of false positives for annual versus biennial mammograms commencing at age 40 or 50. Breast Cancer Res Treat. 149(1):211-21, 2015
                          20. Yaffe MJ et al: Clinical outcomes of modelling mammography screening strategies. Health Rep. 26(12):9-15, 2015
                          21. Webb ML et al: A failure analysis of invasive breast cancer: most deaths from disease occur in women not regularly screened. Cancer. 120(18):2839-46, 2014
                          22. Kerlikowske K et al: Outcomes of screening mammography by frequency, breast density, and postmenopausal hormone therapy. JAMA Intern Med. 173(9):807-16, 2013
                          23. O'Meara ES et al: Mammographic screening interval in relation to tumor characteristics and false-positive risk by race/ethnicity and age. Cancer. 119(22):3959-67, 2013
                          24. Hendrick RE et al: United States Preventive Services Task Force screening mammography recommendations: science ignored. AJR Am J Roentgenol. 196(2):W112-6, 2011
                          25. Wu JC et al: Estimation of natural history parameters of breast cancer based on non-randomized organized screening data: subsidiary analysis of effects of inter-screening interval, sensitivity, and attendance rate on reduction of advanced cancer. Breast Cancer Res Treat. 122(2):553-66, 2010
                          26. Mandelblatt JS et al: Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms. Ann Intern Med. 151(10):738-47, 2009
                          27. Randall D et al: Annual or biennial mammography screening for women at a higher risk with a family history of breast cancer: prognostic indicators of screen-detected cancers in New South Wales, Australia. Cancer Causes Control. 20(5):559-66, 2009
                          28. White E et al: Biennial versus annual mammography and the risk of late-stage breast cancer. J Natl Cancer Inst. 96(24):1832-9, 2004
                          29. Carlson KL et al: Relationship between mammographic screening intervals and size and histology of ductal carcinoma in situ. AJR Am J Roentgenol. 172(2):313-7, 1999
                          30. Hunt KA et al: Outcome analysis for women undergoing annual versus biennial screening mammography: a review of 24,211 examinations. AJR Am J Roentgenol. 173(2):285-9, 1999
                          31. Michaelson JS et al: Breast cancer: computer simulation method for estimating optimal intervals for screening. Radiology. 212(2):551-60, 1999
                          32. Feig SA et al: Radiation risk from screening mammography of women aged 40-49 years. J Natl Cancer Inst Monogr. 119-24, 1997
                          33. Moskowitz M: Breast cancer: age-specific growth rates and screening strategies. Radiology. 161(1):37-41, 1986