Early screening and detection are key to reducing mortality rates for women with breast cancer. This is when you should begin screening.
In the United States, breast cancer remains the most common cancer in women, after skin cancer. It is also the second most common cause of cancer death in women, after lung cancer. According to the National Breast Cancer Institute, it is estimated that approximately 310,720 new breast cancer cases will be diagnosed and 42,250 people will die from breast cancer in 2024.
Early detection with screening mammograms remains the most widely studied and most definitively proven method to decrease the risk of dying from breast cancer. Yearly screening mammograms reduce the risk of dying from breast cancer by up to 40%. Plus, when breast cancers are diagnosed early by screening, they are less likely to require aggressive surgeries and chemotherapy than when breast cancers are detected clinically (i.e., by feeling a breast lump or other symptoms).
Perhaps just as important is that women should undergo a cancer risk assessment. This assessment determines whether someone has a higher-than-average risk of developing breast cancer in their lifetime. Individuals with an elevated breast cancer risk may benefit from more intensive screening options and/or strategies to decrease their risk.
Age 25
Have a breast cancer risk assessment with your healthcare provider. This recommendation is especially important for African American and Ashkenazi Jewish women since they are at higher risk of developing breast cancer at a younger age than non-Jewish white women.
Following a risk assessment, some women may have a higher-than-average risk of developing breast cancer, especially if they inherited a genetic mutation or underwent cancer treatment involving radiation therapy to the chest at a young age. These higher-risk women should have a yearly breast MRI screening starting at age 25-30. A breast MRI has a higher chance of finding breast cancer earlier than mammograms in this population. Start yearly mammogram screenings at age 30 in addition to breast MRIs.
See your healthcare provider if you have any new or unexplained breast problems that do not resolve on their own. Your healthcare provider may order a breast ultrasound to evaluate the problem. A diagnostic mammogram, breast MRI, or biopsy may also be indicated, depending on your symptoms.
Age 40
Have a breast cancer risk assessment with your healthcare provider, if not done already. All women should start undergoing screening mammography once a year.
Women who are at higher-than-average risk should continue yearly mammograms. Yearly mammograms find cancers earlier and reduce the risk of dying from breast cancer than mammograms performed every other year. For women at higher-than-average risk of developing breast cancer, continue to undergo a yearly breast MRI screening in addition to yearly mammograms.
See your healthcare provider at any age if you have any new or unexplained breast problems that do not resolve on their own. Your healthcare provider may order a breast ultrasound to evaluate the problem. A diagnostic mammogram, breast MRI, or biopsy may also be indicated, depending on your symptoms.
Age 70 and over
Have a breast cancer risk assessment with your healthcare provider, if not done already. All women should have screening mammograms once a year and continue for as long as they are in good health.
Screening mammograms continue to reduce the risk of dying from breast cancer in the elderly population. Screening mammograms decrease the need for aggressive surgeries and chemotherapy when breast cancer is diagnosed in the elderly population.
See your healthcare provider at any age if you have any new or unexplained breast problems that do not resolve on their own. Your healthcare provider may order a breast ultrasound to evaluate the problem. A diagnostic mammogram, breast MRI, or biopsy may also be indicated depending on your symptoms.
Women with dense breasts
Breast density refers to the proportion of fibrous and glandular tissue in the breast compared to fatty tissue. Dense breasts have a higher proportion of fibrous and glandular tissue compared to fatty tissue. Non-dense breasts have a lower proportion of fibrous and glandular tissue compared to fatty tissue.
Roughly half of all women have dense breasts, and women with dense breasts have a higher risk of developing breast cancer than women with non-dense breasts. Mammograms are less effective in finding breast cancer in women with dense breasts because the dense breast tissue can obscure cancers.
Women with dense breasts may benefit from supplemental imaging in addition to annual screening mammograms. Breast MRIs, ultrasounds, or contrast-enhanced mammograms are potential imaging techniques that improve breast cancer detection in women with dense breasts. Supplemental imaging is especially important to consider for women with dense breasts and a higher-than-average breast cancer risk.
Transgender individuals
Transfeminine (male-to-female) individuals with 5 years or more of hormone use should undergo yearly screening mammograms starting at age 40. Transmasculine (female-to-male) individuals who have not had a double mastectomy should also undergo yearly screening mammograms starting at age 40.
If transgender individuals are found to be at higher-than-average breast cancer risk, consider earlier and more intensive breast cancer screening, just as cisgender women would. See your healthcare provider at any age if you have any new or unexplained breast problems that do not resolve on their own. Your healthcare provider may order a breast ultrasound to evaluate the problem. A diagnostic mammogram, breast MRI, or biopsy may also be indicated, depending on your symptoms.
All women should have a cancer risk assessment at age 25. If found to be at a higher-than-average risk for breast cancer, these women may start intensive breast cancer screening. At age 40, average-risk women should start yearly screening mammograms and continue for as long as they are in good health. This screening strategy provides the most life-saving benefit for breast cancer early detection. Also, new breast symptoms should be brought to the attention of a healthcare provider as soon as possible for evaluation.
