Breast cancer screening in women at average risk and high risk

Recent controversies over the recommendations for breast cancer screening have created some uncertainty about the best methods of providing this care for women, particularly women at average risk for breast cancer. This article reviews the current recommendations for breast cancer screening from various national organizations and the scientific data behind these recommendations, and it highlights some of the controversies and the reasons behind the differing viewpoints. This article focuses on providing the obstetrician-gynecologist with evidence-based recommendations for counseling and screening women who are at average and high risk for breast cancer. The ability to identify women at higher risk for breast cancer and the appropriate clinical use of mammography, ultrasonography, MRI, clinical breast examination, and self-breast examination ("breast self-awareness") for breast cancer screening in these different populations are discussed. Finally, incorporating specific recommendations for breast cancer screening in women at average and high risk into practice are included.