Breast cancer screening is an important part of preventive care for many women, but knowing when to start and how often to have a mammogram can be confusing. Your age, family history, personal health history and other risk factors can all affect your screening recommendations.
If you are in your 40s, 50s or beyond, understanding the basics of breast cancer screening can help you have a more informed conversation with your healthcare provider and make a screening plan that fits your individual needs.
When Should You Start Getting Mammograms?
For women at average risk of breast cancer, the American Cancer Society recommends that women ages 40 to 44 have the option to begin annual mammograms. Women ages 45 to 54 are generally encouraged to have annual mammograms, while women 55 and older can transition to mammograms every two years or continue yearly screening.
The American College of Radiology recommends annual mammography beginning at age 40 for women at average risk.
Why can recommendations differ?
Breast cancer screening involves weighing the benefits of detecting cancer early with potential downsides, such as false-positive results and additional testing. Medical organizations may interpret the available evidence differently and make somewhat different recommendations.
Your healthcare provider can help you understand your options and determine an appropriate screening schedule based on your age, health history, risk factors and preferences.
What Changes in Your 40s?
Your 40s are an important time to begin talking with your healthcare provider about breast cancer risk and screening.
Breast cancer risk increases with age, and most breast cancers are diagnosed after age 50.
If you have not already discussed breast cancer screening with your primary care provider, your 40s are a good time to start that conversation.
During a preventive visit, your provider can review factors such as:
- Your personal and family history of breast cancer
- Your reproductive history
- Previous breast biopsies or abnormal breast findings
- Genetic factors
- Previous radiation treatment to the chest
- Breast density, when known
- Other factors that may affect your individual risk
Your screening plan may be different if you have factors that put you at higher-than-average risk.
What About Your 50s?
For many women, regular mammograms are already part of their preventive care routine by their 50s.
The American Cancer Society recommends annual mammograms for women ages 45 to 54. Beginning at age 55, women can continue annual screening or transition to screening every two years, as long as they are in good health and expected to live at least 10 more years.
The American College of Radiology recommends continuing annual screening for women age 40 and older.
Your healthcare provider can help you determine which screening schedule is appropriate for you.
If you have been getting regular mammograms, continue keeping track of when your next screening is due. If you have fallen behind, talk with your healthcare provider about getting back on schedule.
What About Breast Cancer Screening After 75?
As you get older, decisions about continuing mammograms become more individualized.
The American Cancer Society recommends that women continue breast cancer screening as long as they are in good overall health and have a life expectancy of at least 10 years.
Your healthcare provider can help you weigh the potential benefits of continued screening alongside your overall health, previous screening history and personal preferences.
Rather than assuming that screening should automatically stop at a particular age, discuss your options with your healthcare provider.
Does Family History Change When You Should Get Screened?
It can.
Having a mother, sister or daughter who has had breast cancer can increase your risk. Risk may also be higher if multiple family members have had breast or ovarian cancer, if a relative was diagnosed at a young age, or if there is a history of breast cancer in a male relative.
Inherited genetic changes, including changes in the BRCA1 and BRCA2 genes, can also significantly increase the risk of breast and ovarian cancer.
If breast or ovarian cancer runs in your family, tell your primary care provider. Your provider can help determine whether you may benefit from a formal risk assessment, genetic counseling or a different screening approach.
Women at high risk may need screening that begins earlier or includes additional imaging. The American Cancer Society recommends that some women at high risk receive an annual breast MRI in addition to a mammogram.
What Does Breast Density Have to Do With Screening?
You may see information about breast density on your mammogram report.
Breast density describes the amount of fibrous and glandular tissue compared with fatty tissue in the breast. Dense breasts are common, with about half of women age 40 and older having dense breast tissue.
Breast density is important for two reasons. Having dense breasts is associated with a higher risk of breast cancer, and dense tissue can make some cancers more difficult to see on a mammogram.
Being told you have dense breasts does not mean you have cancer, and it does not mean that a mammogram is no longer useful.
Instead, talk with your healthcare provider about your overall breast cancer risk and whether additional screening may be appropriate for you.
What If You Notice a Change in Your Breast?
Screening mammograms are designed to look for breast cancer before symptoms develop. They are not a substitute for discussing a new or concerning breast change with your healthcare provider.
Contact your provider if you notice a new or unusual change, such as:
- A new lump or thickened area
- A change in the size or shape of the breast
- Changes to the skin of the breast
- New nipple changes or discharge
- Persistent breast pain or another change that concerns you
Not every breast change is caused by cancer. Many changes have other explanations.
However, a new or persistent change should be evaluated rather than waiting for your next routine mammogram.
Mammograms Are Not the Only Part of Breast Health
Keeping up with mammograms is important, but breast health involves more than screening.
Your primary care visits are an opportunity to discuss your personal and family history, review risk factors and determine whether you are due for other preventive screenings.
It is also important to know what is normal for your breasts and to report changes to your healthcare provider. The American Cancer Society recommends that women be familiar with how their breasts normally look and feel and report changes promptly.
What Should You Ask Your Primary Care Provider?
If you are unsure whether you are due for a mammogram or whether you may need a different screening approach, consider asking:
- When should I start having mammograms?
- How often should I be screened?
- Do I have any risk factors that change my screening recommendations?
- Does my family history affect my risk?
- Should I have a breast cancer risk assessment?
- What does my breast density mean?
- Do I need additional screening beyond a mammogram?
- What breast changes should I report?
Your answers may change over time, which is why breast cancer screening is an important part of an ongoing relationship with your healthcare provider.
Make Breast Cancer Screening Part of Your Preventive Care
There is no single screening schedule that is right for every person. Your age, health history, family history and other risk factors all play a role in determining when and how often you should be screened.
If you are due for a mammogram—or simply aren’t sure when your next one should be—talk with your Avance Care primary care provider. We can help you stay on top of recommended preventive care and determine what screenings are appropriate for your individual health needs.
Schedule a preventive care visit with Avance Care today.
