"Key Points

Question  Are breast cancer screening strategies personalized by a woman’s 5-year absolute risk associated with improved effectiveness and reduced harms compared with traditional age-based screening approaches?

Findings  In this decision analytical model using collaborative simulation modeling of 2 validated CISNET models, 9 risk-based screening strategies were associated with a comparable or greater number of averted breast cancer deaths than biennial age-based screening from ages 40 to 74 years (B40-74) and reduced false-positive recalls by 8% to 23%. For example, compared with B40-74, a risk-based strategy would be associated with 6% more averted breast cancer deaths and 13% fewer false-positive recalls per 1000 women.

Meaning  This study suggests that risk-based mammography screening using 5-year absolute risk may be associated with improved breast cancer mortality outcomes and reduced harms compared with age-based screening approaches."