Mammographic screening: why the age range should not be relaxed

In September 2025, the Brazilian Ministry of Health announced a subtle change in its guidance to professionals on the age range for mammographic breast cancer screening: it recommended shared and informed decision-making when women aged 40-49 years request screening. One social effect of this is to qualify the contraindication to screening in this age range, which may have harmful health effects. We present a critique of this announcement, based on theoretical and technical aspects, ethical considerations, and scientific evidence. We criticize the absence of technical criteria and relevant empirical evidence underlying the new guidance, against the backdrop of the persistence, for more than a decade, of scientific controversy over the benefit–harm balance of this screening, which, however, has neither become widely known nor influenced the decisions of the vast majority of medical and public health institutions in countries that recommend this screening. The persistence of this controversy and the absence of relevant new evidence suggest a direction contrary to the new ministerial guidance.