Following a systematic review by the U.S. Preventive Services Task Force to evaluate the comparative effectiveness of different breast cancer screening strategies by age, the task force announced today that it now recommends biennial screening mammography for women beginning at the age of 40 years (revising its current recommendation of 50) until women reach the age of 74 years. (It classifies today's announcement as a B recommendation, meaning that that USPSTF recommends that clinicians provide the service to eligible patients.)  

Ordinarily, USPSTF preventive services recommendations impact patient reimbursement while also eliminating out-of-pockets costs. The Patient Protection and Affordable Care Act (ACA) mandates coverage without co-pay or deductible payments for preventive services recommended by the USPSTF. But, unlike other USPSTF recommendations, these task force breast cancer screening recommendations changes will not directly change the ACA's list of cancer screenings, immunizations and contraceptives that are made available without co-pay and deductible costs to patients.  That is because Federal law adopted prior to ACA’s enactment began screening at age 40, rather than the task force’s prior recommendations for screening every two years beginning at age 50 in place until this announcement.

At the same time, disappointingly, USPSTF has concluded that the current evidence is insufficient to recommend supplemental screening for breast cancer using breast ultrasound or breast MRI in women identified to have dense breasts on an otherwise negative screening mammogram. There has been much recent concern raised by patient advocacy groups over the lack of coverage for additional breast imaging services for asymptomatic women who are found to have dense breasts.

Today’s action is certainly a positive change, of course. Much still needs to be done for women with dense breasts to remove out-of-pocket cost for them to receive necessary additional breast imaging services beyond screening mammography.