Mammographic screening: why we shall not widen the age range

Abstract

In September 2025, the Brazilian Ministry of Health announced a subtle change in its guidance to professionals regarding mammographic screening for breast cancer, specifically concerning age range: it recommended a shared and informed decision when women request screening in the 40-49 age range. A social effect of this is the relativization of the contraindication for screening in this age range, which may have detrimental health effects. We present a critique of this announcement, based on theoretical-technical, ethical, and scientific evidence aspects. We criticize the absence of relevant technical criteria and empirical evidence underlying the new guidance, against the backdrop of persistent scientific controversy, for more than a decade, regarding the benefit-harm balance of this screening, which, however, has not become popularized nor influenced the decisions of the vast majority of medical and public health institutions in the countries that recommend this screening. The persistence of this controversy and the lack of new relevant evidence suggest a direction contrary to the new ministerial guidance.