• These recommendations are based on the guidelines from the National Institute for Health and Clinical Excellence (NICE) [NICE, 2006a].
• There is uncertainty about the optimum age and frequency of mammographic and magnetic resonance imaging screening because the evidence base is incomplete [NICE, 2006a].

Recommendations for mammographic surveillance

• For women 50–69 years of age, mammographic surveillance has been shown to reduce mortality from breast cancer [National Collaborating Centre for Primary Care, 2006].
• The benefits of mammography in women 30–49 years of age is uncertain. Some evidence suggests a possible benefit in women 40–49 years of age if they have an increased risk; based on this, NICE suggests mammographic screening in this group [NICE, 2006a].
• Mammographic screening in women younger than 40 years of age or older than 69 years of age is not recommended as there is almost no evidence for benefit in this age group. It is known that the density of breast tissue in younger women, particularly those younger than 30 years of age, means that a mammogram is unlikely to be informative [NICE, 2006a]. Surveillance is less sensitive in younger women, in women with a family history of breast cancer, and in carriers of the BRCA1 or BRCA2 mutation [Kerlikowske et al, 1996; Kerlikowske et al, 2000; Goffin et al, 2001].
• The risk of radiation-induced breast cancer is small compared with the benefits of cancer detection. The margin of benefit over risk is sufficient in women with a family history of breast cancer to support screening from 40 years of age [Law, 1997; Law and Faulkner, 2001].