ACR & SBI Rebuff New ACP Guidelines

The American College of Radiology (ACR) and Society of Breast Imaging (SBI) recently rebuffed the new breast cancer screening guidelines as outlined by the American College of Physicians (ACP).

In one of their statements, the ACP now recommends that patients seek biennial screening starting at age 50, instead of annual screening starting at age 40. According to the ACP, women screened yearly receive more abnormal results (7% versus 4.8%) than patients screening every other year.

Additionally, they further state that average-risk women between the ages of 40 and 49 should be in discussion with their primary care physicians about breast cancer screening.

The ACR and SBI were quick to respond, posting their rebuttal within a day of the announcement. In addressing the claim that biennial screening results in no significant difference in breast cancer mortality, they state, “There have been no randomized controlled trials to test this ACP claim.” They further cite NCI models that show, “a major decline in deaths among women screened annual instead of every other year.”

There are also conflicting definitions of what defines “average risk,” which was one of the points brought up by Dr. Joanne Elmore and Dr. Chrisoph Lee. They also expressed concern regarding how discussions between patients and their care providers would happen.

The ACR and SBI also suggested that the ACP guidelines are likely to worsen racial disparities in breast cancer outcomes, especially for African American women. These organizations further stated that the thousands of lives saved each year by annual mammography screening beginning at age 40 are not outweighed by the short-term anxiety from test results, the recall rate, and the overdiagnosis claims.

The response has been mixed so far.

• Hugh Harvey (@DrHughHarvey) commented on Twitter: “Very interesting – @RadiologyACR and @BreastImaging essentially reject what is standard practice across Europe – biennial screening starting at 50.”
• AuntMinnie.com (@AuntMinnie) also posted: “No randomized controlled trials have tested the ACP claim of no difference in mortality rates for biennial versus annual screening, said @RadiologyACR and SBI. #mammography #radiology”

The discussion is likely just beginning, though, as other organizations and luminaries in the field will react and respond in the days ahead. Stay tuned to the MagView blog and follow us on LinkedIn for more news regarding breast imaging protocol and policy changes.