Table 4.
Lifetime harms of screening annually, biennially or triennially per 1000 women screened by relative risk, breast density, and age group
| Density and RR | False-positives vs. no screening, median (range across models) | Benign biopsies vs. no screening, median (range across models) | Over-diagnosis vs. no screening, median (range across models)* | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Triennial | Biennial | Annual | Triennial | Biennial | Annual | Triennial | Biennial | Annual | |
| Ages 50–74† | |||||||||
| Almost entirely fatty | |||||||||
| 1 | 489 (424–616) | 618 (613–858) | 1101 (1094–1548) | 79 (68–106) | 91 (91–136) | 127 (127–191) | 11 (9–17) | 12 (11–20) | 17 (12–24) |
| 1.3 | 484 (420–611) | 612 (606–851) | 1089 (1081–1536) | 78 (67–106) | 91 (90–135) | 126 (125–190) | 12 (11–21) | 15 (11–26) | 21 (12–31) |
| 2 | 471 (412–600) | 598 (590–836) | 1062 (1051–1507) | 76 (66–104) | 89 (88–133) | 123 (122–187) | 17 (11–31) | 22 (11–37) | 30 (12–44) |
| 4 | 438 (390–571) | 564 (547–794) | 996 (972–1429) | 71 (63–99) | 84 (81–126) | 116 (113–177) | 27 (11–53) | 35 (11–63) | 49 (12–75) |
| Scattered areas of fibroglandular density | |||||||||
| 1 | 781 (693–935) | 1009 (991–1326) | 1806 (1776–2440) | 126 (111–158) | 150 (147–206) | 209 (206–296) | 13 (11–22) | 17 (11–27) | 23 (12–35) |
| 1.3 | 767 (683–922) | 994 (972–1309) | 1776 (1740–2406) | 123 (110–156) | 148 (144–203) | 206 (202–292) | 16 (11–28) | 20 (11–34) | 29 (12–44) |
| 2 | 734 (662–894) | 963 (929–1267) | 1714 (1659–2329) | 118 (107–152) | 143 (138–197) | 199 (193–283) | 21 (10–39) | 28 (11–48) | 39 (12–62) |
| 4 | 649 (613–818) | 888 (818–1158) | 1568 (1452–2123) | 105 (99–140) | 132 (122–181) | 183 (169–259) | 31 (11–60) | 40 (12–74) | 56 (13–95) |
| Heterogeneously dense | |||||||||
| 1 | 917 (822–1064) | 1197 (1171–1524) | 2123 (2080–2829) | 163 (146–195) | 178 (174–235) | 266 (261–365) | 16 (10–20) | 20 (11–26) | 28 (12–38) |
| 1.3 | 894 (807–1043) | 1174 (1141–1493) | 2078 (2023–2771) | 159 (144–191) | 174 (169–230) | 261 (254–358) | 19 (10–25) | 24 (11–32) | 34 (12–46) |
| 2 | 842 (775–995) | 1125 (1073–1424) | 1984 (1896–2642) | 150 (138–183) | 167 (160–220) | 249 (238–342) | 25 (10–34) | 32 (11–44) | 45 (13–63) |
| 4 | 715 (703–875) | 1016 (906–1248) | 1778 (1585–2308) | 128 (126–162) | 152 (136–194) | 224 (200–301) | 32 (11–49) | 41 (12–63) | 57 (14–89) |
| Extremely dense | |||||||||
| 1 | 732 (652–849) | 939 (925–1200) | 1668 (1647–2225) | 130 (116–156) | 139 (137–185) | 209 (206–288) | 16 (10–17) | 21 (11–22) | 31 (12–32) |
| 1.3 | 712 (638–827) | 917 (898–1169) | 1626 (1597–2167) | 127 (113–152) | 136 (133–181) | 204 (200–281) | 19 (10–21) | 26 (11–27) | 37 (12–39) |
| 2 | 666 (608–780) | 872 (839–1102) | 1540 (1487–2039) | 119 (108–144) | 129 (125–171) | 193 (186–265) | 26 (10–26) | 34 (11–35) | 47 (13–53) |
| 4 | 555 (543–663) | 776 (697–933) | 1359 (1223–1719) | 99 (97–123) | 116 (104–146) | 171 (154–225) | 32 (10–37) | 41 (12–49) | 56 (15–74) |
| Ages 65–74‡ | |||||||||
| Almost entirely fatty | |||||||||
| 1 | 145 (137–169) | 209 (206–227) | 413 (395–459) | 22 (20–25) | 29 (29–32) | 45 (43–51) | 5 (4–8) | 6 (5–11) | 9 (5–13) |
| 1.3 | 142 (135–166) | 206 (202–224) | 405 (388–453) | 21 (20–25) | 29 (28–31) | 45 (43–50) | 7 (4–10) | 8 (5–14) | 11 (5–17) |
| 2 | 135 (130–160) | 198 (193–217) | 387 (373–438) | 20 (20–24) | 28 (27–30) | 43 (41–48) | 9 (4–15) | 11 (5–20) | 15 (6–25) |
| 4 | 119 (118–145) | 178 (169–197) | 340 (335–399) | 18 (18–22) | 25 (24–28) | 37 (37–44) | 14 (5–25) | 16 (6–34) | 22 (7–41) |
| Scattered areas of fibroglandular density | |||||||||
| 1 | 230 (225–278) | 343 (333–375) | 667 (648–757) | 34 (34–42) | 48 (47–52) | 73 (71–83) | 7 (4–10) | 8 (5–15) | 12 (5–20) |
| 1.3 | 223 (220–271) | 335 (322–366) | 645 (632–741) | 33 (33–41) | 47 (45–51) | 71 (69–81) | 8 (4–13) | 10 (5–19) | 14 (6–24) |
| 2 | 209 (206–257) | 317 (298–348) | 597 (597–704) | 31 (31–39) | 44 (42–49) | 66 (66–77) | 11 (5–18) | 13 (6–26) | 18 (6–34) |
| 4 | 180 (166–225) | 276 (239–299) | 520 (480–607) | 27 (25–34) | 39 (33–42) | 57 (53–67) | 14 (5–27) | 17 (7–38) | 23 (8–50) |
| Heterogeneously dense | |||||||||
| 1 | 273 (260–329) | 407 (397–432) | 794 (760–875) | 46 (44–56) | 57 (56–61) | 95 (91–105) | 8 (4–10) | 10 (5–14) | 14 (6–20) |
| 1.3 | 262 (250–319) | 394 (381–417) | 762 (735–845) | 45 (43–54) | 55 (53–58) | 91 (88–101) | 10 (5–12) | 12 (6–17) | 17 (7–25) |
| 2 | 238 (230–298) | 367 (346–384) | 693 (684–779) | 41 (39–51) | 51 (48–54) | 83 (82–93) | 12 (5–16) | 15 (7–23) | 21 (8–33) |
| 4 | 182 (181–254) | 302 (264–311) | 580 (528–617) | 31 (31–43) | 42 (37–44) | 70 (63–74) | 13 (6–22) | 16 (8–32) | 22 (10–46) |
| Extremely dense | |||||||||
| 1 | 202 (187–239) | 295 (291–312) | 583 (553–631) | 34 (32–41) | 41 (41–44) | 70 (66–76) | 7 (4–9) | 10 (6–11) | 15 (7–17) |
| 1.3 | 193 (179–231) | 284 (279–298) | 559 (532–604) | 33 (30–39) | 40 (39–42) | 67 (64–72) | 9 (5–10) | 12 (6–13) | 18 (7–20) |
| 2 | 175 (161–214) | 263 (253–268) | 507 (491–544) | 30 (27–36) | 37 (35–37) | 61 (59–65) | 12 (5–12) | 15 (7–17) | 21 (9–27) |
| 4 | 133 (118–180) | 197 (191–221) | 404 (383–412) | 23 (20–31) | 28 (27–31) | 49 (46–49) | 12 (6–16) | 14 (9–24) | 20 (11–38) |
Abbreviations: RR, relative risk.
*
Over-diagnosed cases are defined as cases that would not have been clinically detected in the absence of screening. The value includes DCIS and invasive over-diagnosis. Over-diagnosis is calculated by comparing cases detected in the screening scenario to those detected in the unscreened scenario.
†
Per 1000 women compared to no screening at any age.
‡
Per 1000 women compared to biennial mammograms 50–64 with no subsequent screening.