ACP Updates Breast Cancer Screening Guidance

New recommendations support biennial screening for women aged 50-74, with individualized decisions for younger and older women.

Apr. 20, 2026 at 8:04am

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An extreme close-up X-ray photograph revealing the intricate internal structure of breast tissue, conceptually illustrating the nuanced approach to breast cancer screening recommendations.New breast cancer screening guidelines aim to balance the benefits and harms of mammography, especially for women with dense breast tissue.Boston Today

The American College of Physicians (ACP) has updated its guidance on breast cancer screening for asymptomatic, average-risk women. The new recommendations include biennial mammography for those aged 50-74, shared decision-making for women 40-49 and those 75+, and advice against supplemental MRI or ultrasound for women with dense breasts.

Why it matters

The updated ACP guidance aims to balance the benefits and harms of breast cancer screening, addressing concerns around overdiagnosis, overtreatment, and false positives that can lead to unnecessary stress and reduced adherence to future screening.

The details

The key recommendations include: 1) Biennial mammography for women aged 50-74, 2) Shared decision-making for women 40-49 and those 75+, considering individual risk and preferences, 3) No recommendation for supplemental MRI or ultrasound for women with dense breasts, and 4) Continued advice against routine breast self-exams.

  • The ACP published the updated guidance in April 2026.

The players

Amir Qaseem

The ACP's chief scientific officer and senior vice president of clinical policy, who led the panel that developed the updated breast cancer screening guidance.

Mara A. Schonberg

A Boston internist, professor of medicine at Harvard Medical School, and director of research in shared decision-making at Beth Israel Deaconess Medical Center, who provided comments on the new recommendations.

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What they’re saying

“This updated guidance statement is based on new data and new or updated guidelines evaluated by the ACP since the publication of our 2019 guidance statement, which is over 7 years old.”

— Amir Qaseem, Chief Scientific Officer and Senior Vice President of Clinical Policy, ACP

“These are very thoughtful and reasonable recommendations based on new data. They address a number of issues based on data from mixed study types from randomized controlled trials and observational studies to modeling data.”

— Mara A. Schonberg, Professor of Medicine, Harvard Medical School

What’s next

The ACP's updated breast cancer screening guidance will likely influence clinical practice and screening recommendations from other major medical organizations in the coming years.

The takeaway

The ACP's new guidance aims to provide a more nuanced, evidence-based approach to breast cancer screening that accounts for individual risk factors and preferences, while reducing potential harms from overdiagnosis and overtreatment.