Women aged 40-74 without personal or family history of breast cancer, known BRCA1 or 2 mutation, or prior chest wall radiation

Burden of illness

There were approximately 22,700 new cases of breast cancer and 5,400 deaths from breast cancer in Canada during 2009. Incidence and case-fatality rates increase with age.


Mammography (film or digital)


For every 1,000 women screened for about 11 years

About 5 women will unnecessarily undergo surgery for breast cancer

Details of recommended service

For women aged 50-74 we suggest screening every 2 to 3 years, which appears to preserve nearly all of the benefit of annual screening but reduces adverse effects, inconvenience to women and cost. No data from our review address the benefits of screening in women younger than 40 or older than 74 but benefit is likely lower than in women aged 50-74. Either digital or film mammography is acceptable. Screening with magnetic resonance imaging is not recommended.

Considerations for implementation

Consider providing your patients who are aged 40 to 74 with the Decision Aid for Breast Cancer Screening in Canada: https://canadiantaskforce.ca/resources/tools/

Consider using your electronic health record to flag a screening reminder for patients aged 50 to 74 every 3 years; this can be particularly useful if you don't have a local screening program that generates automated reminders to patients

Special considerations

Certain ethnic groups may have higher (e.g. Ashkenazi Jews) or lower (East Asians) risk of breast cancer, which may increase or reduce the absolute benefit of screening, respectively. Rates of screening are low in Aboriginal populations, and further work is needed to determine how this can be improved.

Given the small absolute benefit of screening, benefit is uncertain in people whose life expectancy is substantially reduced by comorbid conditions. For people with comorbidity but normal or near-normal life expectancy, potential determinants of risk and benefit should be discussed.

Provincial and regional decision-makers should consider whether access to high quality screening facilities is adequate for people residing outside major centers.

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