Abstract
Breast cancer screening helps detect cancer at an early stage. Occupational health nurses must understand the importance of screening to deliver safe care. This article highlights the USPFTS (2024) guidelines on breast cancer screening for average-risk workers.
Keywords
In the United States, the American Cancer Society (ACS) (2025) reported that estimated new breast cancer cases and deaths in 2024 are approximately 310,720 new cases of invasive breast cancer and 56,500 new cases of ductal carcinoma in situ. Also, ACS (2025) discussed that breast cancer accounts for about 30% of all new female cancers each year. Black women have the highest death rate from breast cancer (ACS, 2025). Research revealed that 83% of women who are diagnosed with invasive breast cancer are 50 years of age and older (Centers for Disease Control and Prevention [CDC], 2024). The incidence rate of breast cancer remains slightly higher in White women as compared with Black women. Yet, non-Hispanic Black women have the highest mortality rate (CDC, 2024). They also tend to have low wages and little access to resources (e.g., insurance), thus less likely to get screening (Aleshire et al., 2021). Breast cancer has the highest treatment cost (14% of any cancer), with medical services costing US$26.2 billion and prescription drugs US$3.5 billion (CDC, 2024).
Workplace exposures to hazards such as night-shift and pesticides increase workers’ risks for breast cancer (Breast Cancer Prevention Partners [BCPP], 2025). Also, solvents, ionizing radiation, and sedentary work are predisposing factors to breast cancer (BCPP, 2025). Workers such as nurses, flight attendants, physicians, production workers, teachers, hairdressers, cosmetologists, and retail sales associates, may be exposed to specific compounds that are linked to an increased risk of breast cancer (BCPP, 2025).
The United States Preventive Services Task Force’s (USPSTF, 2024) guidelines delineate biennial screening with mammograms (2D) or tomosynthesis (3D) for all women (e.g., transgender men and nonbinary persons, cisgender women, and all other assigned females at birth) starting at age 40. A 2D mammogram has a low-dose X-ray; potential harms when screening with mammograms include false-positive results, which may lead to invasive follow-up procedures, psychological harm, overtreatment, and overdiagnosis of unharmful lesions that were not detected during screening. Although tomosynthesis can detect more cancers and reduce the amount of false-positive results, radiation exposure is a concern. Also, based on USPSTF’s guidelines, screening individuals ages 75 and older is not recommended. We lack empirical data on the benefits and harms of screening women aged 75 or older.
There have been debates on screening women who have dense breasts with a negative mammogram. The guidelines from USPSTF noted a lack of evidence available to assess the benefits and harms of supplemental tests such as ultrasound or magnetic resonance imaging (MRI). These tests are helpful during screening; however, they are not the initial diagnostic tests to screen average-risk workers for breast cancer.
Breast cancer disparities and inequities are found in breast cancer stage of mortality, diagnosis, and subtype. Beyond Stage 1, Black women are more likely to be diagnosed with triple-negative cancers (i.e., ER–, PR–, and HER2–; CDC, 2024); they are more aggressive tumors. Thus, 40% of black women are more likely to die of breast cancer as compared with White women (CDC, 2024). The USPSTF raises awareness to assess breast cancer disparities by race and ethnicity and highlights the benefits of screening. USPSTF also acknowledges that providers should conduct follow-up evaluations, perform tissue biopsies, implement shared decision-making, and prescribe additional testing. For health disparities, USPSTF supports equitable screening and timely and effective treatment to reduce mortality and increase breast cancer survival rates.
Occupational Health Nurses (OHN) need to develop adequate knowledge and skills to raise awareness about breast cancer screening, provide screening information, and perform risk assessments to support vulnerable workers with breast cancer. They need to understand the optimal start and stop age for breast cancer screening and intervals for positive health outcomes. Also, OHN must discuss with workers about supplemental tests for dense breasts and diagnostic modalities to help them live healthier lives.
