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Breast cancer screening shared decision-making — MCCQE Part 1 MCQ

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ModeratePreventive MedicineBreast cancer screening shared decision-makingMCCQE Part 1

47-year-old woman at average risk presents with asking about mammography. She has no breast symptoms and no family history. Which of the following is the most appropriate next step?

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Correct answer: C — Discuss benefits and harms and use shared decision-making rather than automatically screening annually

Discuss benefits and harms and use shared decision-making rather than automatically screening annually is best because Canadian screening recommendations emphasise shared decision-making in younger average-risk women. Use a United States screening schedule instead of Canadian guidance is suboptimal because MCCQE questions expect Canadian preventive-care guidance; Defer all preventive care until symptoms develop is suboptimal because screening and immunisation aim to prevent disease before symptoms; Order the most invasive test as routine first-line screening is suboptimal because screening should balance benefit, harm and resource use; Screen at every visit regardless of interval or prior results is suboptimal because over-screening causes avoidable false positives and harm. Screening decisions should include false positives and overdiagnosis.

Reference: CTFPHC breast cancer screening guidance