Modeling study to compare different breast cancer screening strategies

The effects of breast cancer incidence changes and advances in screening and treatment on outcomes of different screening strategies are not well known. A modeling study of 36 screening strategies with varying start ages (40, 45, 50 years) and stop ages (74,79 years) with digital mammography or digital breast tomosynthesis annually, biennially, or a combination of intervals was carried out. The study found that, compared with no screening, biennial mammography screening with digital breast tomosynthesis from age 40 to 74 yielded a median of 8.2 breast cancer deaths averted per 1000 women screened, equal to a 30% reduction in breast cancer mortality, and 165 life-years gained, 1376 false-positive recalls, 201 benign biopsies, and 14 overdiagnosed cases per 1000 women screened. For each strategy, benefits were larger for Black women than for all women. The authors conclude that biennial mammography from ages 40 to 74 years has favorable benefit-to-harm tradeoffs.