ACR Appropriateness Criteria Breast Cancer Screening

• Published in: Journal of the American College of Radiology Vol. 10; no. 1; pp. 11 - 14
• Main Authors: Mainiero, Martha B., MD, Lourenco, Ana, MD, Mahoney, Mary C., MD, Newell, Mary S., MD, Bailey, Lisa, MD, Barke, Lora D., DO, D'Orsi, Carl, MD, Harvey, Jennifer A., MD, Hayes, Mary K., MD, Huynh, Phan Tuong, MD, Jokich, Peter M., MD, Lee, Su-Ju, MD, Lehman, Constance D., MD, PhD, Mankoff, David A., MD, PhD, Nepute, Joshua A., MD, Patel, Samir B., MD, Reynolds, Handel E., MD, Sutherland, M. Linda, MD, Haffty, Bruce G., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2013
• Subjects: Adult; Aged; Appropriateness criteria; breast cancer; breast MRI; Breast Neoplasms - diagnosis; Breast Neoplasms - pathology; breast ultrasound; Diagnostic Imaging - methods; Early Detection of Cancer - methods; Early Detection of Cancer - standards; Female; Humans; Magnetic Resonance Imaging - methods; Magnetic Resonance Imaging - standards; mammography; Mammography - methods; Mammography - standards; Middle Aged; Patient Selection; Practice Guidelines as Topic; Quality Control; Radiology; screening; Societies, Medical - standards; Ultrasonography, Mammary - methods; Ultrasonography, Mammary - standards; United States; Women's Health; United States; Appropriateness criteria; breast MRI; breast cancer; screening; breast ultrasound; mammography
• ISSN: 1546-1440; 1558-349X
• DOI: 10.1016/j.jacr.2012.09.036

Mammography is the recommended method for breast cancer screening of women in the general population. However, mammography alone does not perform as well as mammography plus supplemental screening in high-risk women. Therefore, supplemental screening with MRI or ultrasound is recommended in selected high-risk populations. Screening breast MRI is recommended in women at high risk for breast cancer on the basis of family history or genetic predisposition. Ultrasound is an option for those high-risk women who cannot undergo MRI. Recent literature also supports the use of breast MRI in some women of intermediate risk, and ultrasound may be an option for intermediate-risk women with dense breasts. There is insufficient evidence to support the use of other imaging modalities, such as thermography, breast-specific gamma imaging, positron emission mammography, and optical imaging, for breast cancer screening. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review includes an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.