New ACR Breast Cancer Screening Guidelines Aim to Improve Racial & Ethnic Disparities in Breast Cancer Outcomes

New ACR Breast Cancer Screening Guidelines Aim to Improve Racial & Ethnic Disparities in Breast Cancer Outcomes

 Updated ACR Guidelines aim to improve racial and ethnic disparities for at risk women  Survival rates are highest when breast cancer is found early—which is one more reason to schedule your mammogram at Bergen Imaging Center in NJ today.

The American College of Radiology (ACR) has issued new breast cancer screening guidelines on May 3, 2023, urging early and more intensive screening for certain high-risk populations, such as Black women and individuals of Ashkenazi Jewish descent. The updated guidelines aim to address disparities in breast cancer outcomes, with the ACR continuing to endorse annual mammography screenings starting at age 40 for women with average risk.

What You Need to Know About the Updated Guidelines

In light of the new guidelines, high-risk patients are advised to undergo earlier and more comprehensive screenings. Those with genetic risk factors, such as BRCA1 carriers, a calculated lifetime risk of 20% or more, or exposure to chest radiation during youth, should commence MRI surveillance between the ages of 25 and 30. Depending on their risk profiles, these individuals are also recommended to start annual mammography screenings between ages 25 and 40.

Women diagnosed with breast cancer before turning 50, or those with a history of the disease and dense breasts, are recommended to receive annual supplemental MRIs. For patients unable to undergo MRI, contrast-enhanced mammography (CEM) or ultrasound may be considered as alternatives for supplemental screenings.

Why Are Black Women, Minorities, at Higher Risk?

The updated guidelines come amid growing evidence that Black women and other minority populations face a higher risk of breast cancer. Despite similar incidence rates, Black women are 42% more likely to die from breast cancer compared to non-Hispanic white women. They are also less likely to be diagnosed with stage I breast cancer but are twice as likely to die from early breast cancers. Furthermore, Black women have double the risk of developing aggressive “triple-negative” breast tumors and a higher incidence of BRCA1 and BRCA2 genetic mutations.

Stamatia Destounis, MD, FACR, co-author of the new guidelines, chair of the American College of Radiology Breast Imaging Commission, and managing partner at Elizabeth Wende Breast Care in Rochester, NY, highlighted the disparities in breast cancer death rates. “Since 1990, breast cancer death rates in Black women, who develop and die from the disease earlier, have only dropped approximately half as fast as in white women,” she said. The ACR aims to save more lives of Black women and others at high risk by regularly updating their recommendations based on the latest evidence.

For Breast Cancer Risk, Age & Ethnicity Matter

A recent study published in JAMA Network Open suggests that Black women should begin breast cancer screening at age 42, eight years earlier than other patients, in order to help close the gap in outcomes. The study, which analyzed mortality data from over 415,000 patients, found that uniform screening guidelines may not be sufficient.

Fallah et al., the authors of the JAMA study, proposed adjusting breast cancer recommendations to include race and ethnicity. They recommended that American Indian, Alaska Native, and Latina women begin screening at 57 years, while Asian or Pacific Islander women start at 61.

The authors argued that the “current one-size-fits-all policy” for screening the “entire female population from a specific age may not be optimal or equitable”. Instead, they suggested adopting risk-adapted starting ages for screening based on readily available risk factors like race and ethnicity.

New ACR Guidelines Drive Informed Conversations, Save More Lives

The updated ACR guidelines, which come after the wide use of mammography contributed to a 43% drop in the U.S. breast cancer death rate among women since the 1980s, aim to further reduce mortality rates in high-risk populations. Debra Monticciolo, MD, primary author of the new guidelines and division chief of Breast Imaging at Massachusetts General Hospital, expressed hope that the evidence-based updates will “spur more-informed doctor-patient conversations and help providers save more lives.”

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