Medical News Today (MNT)New Guidelines Recommend Mammograms Every 2 Years for Older Women

✅ Guideline Update
The American College of Physicians released updated breast cancer screening guidance at the 2026 Internal Medicine Meeting and in Annals of Internal Medicine. The guidance recommends biennial mammography for average-risk women aged 50 to 74, with shared decision-making for those 40 to 49 and discontinuation discussions for those 75 and older.

Clinical Considerations

• Average-risk is defined as no personal or family history of breast cancer, no known high-risk gene variants (BRCA1/BRCA2), and no prior high-dose chest radiation at a young age
• Annual versus biennial screening showed no added mortality benefit but more false-positive recalls and biopsies, per ACP’s review
• Ages 40-49 show a small absolute mortality reduction (only at 45-49) but no difference in advanced cancers, requiring shared decision-making
• Supplemental DBT may be considered for BI-RADS C or D breast density; supplemental MRI or ultrasound is not advised at average risk
• The American College of Radiology and Society for Breast Imaging have publicly voiced concern that the guidance may delay diagnoses in younger women and those with dense breasts

Practice Applications

• Integrate the ACP framework into average-risk screening conversations for ages 50-74
• Recognize active disagreement between ACP and radiology societies on the 40-49 age band
• Consider shared decision-making documentation when patients elect annual screening or screen before 50
• Interpret supplemental imaging recommendations in the context of breast density and patient preference

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