Question: Mammogram guidelines seem to differ about when to begin mammograms — at age 40 or at age 50. When should I start getting mammograms and how often should I have one?
Answer from Sandhya Pruthi, MD: You’re right that there are varying mammogram guidelines from different organizations about when to begin mammograms. Here’s a brief summary.
The American Cancer Society mammogram guidelines call for yearly mammogram screening beginning at age 40 for women at average risk of breast cancer. The Breast Care Center recommendations align with those of the ACS, and annual screening mammography is recommended.
Differing mammogram guidelines
In 2009, the U.S. Preventive Services Task Force (USPSTF) — a group of health experts that reviews published research and makes recommendations about preventive health care — issued revised mammogram guidelines. Those guidelines include the following:
- Screening mammograms should be done every two years beginning at age 50 for women at average risk of breast cancer.
- Screening mammograms before age 50 should not be done routinely and should be based on a woman’s values regarding the risks and benefits of mammography.
- Doctors should not teach women to do breast self-exams.
- There is insufficient evidence that mammogram screening is effective for women age 75 and older, so specific recommendations for this age group were not included.
These guidelines differ from those of the American Cancer Society (ACS). The ACS mammogram guidelines call for yearly mammogram screening beginning at age 40 for women at average risk of breast cancer. Meantime, the ACS says the breast self-exam is optional in breast cancer screening.
According to the USPSTF, women who have screening mammograms die of breast cancer less frequently than do women who don’t get mammograms. However, the USPSTF says the benefits of screening mammograms don’t outweigh the harms for women ages 40 to 49. Potential harms may include false-positive results that lead to unneeded breast biopsies and accompanying anxiety and distress.
What Mayo Clinic recommends
At Mayo Clinic, the current practice is to continue to recommend an annual screening mammogram beginning at the age of 40, which aligns with the ACS recommendation.
At Mayo Clinic, a three-tiered approach is used:
- Breast health awareness, which includes a woman becoming familiar with her breasts in order to identify breast abnormalities or changes, and to inform her doctor of any changes that may need further evaluation
- Clinical breast exam performed by a health care provider and recommended annually beginning at age 40
- Screening mammography beginning at age 40
Screening mammograms can detect breast abnormalities early in women in their 40s. Findings from a large study in Sweden of more than 1 million women in their 40s who received screening mammograms showed a decrease in breast cancer deaths by 29 percent. And it’s important to remember that most women who get breast cancer have no family history or other known risk factors for the disease.
Screening mammography is not a perfect exam. But it is the best available tool to detect cancer early, which can lead to better options and possibly less aggressive treatments.
If you’re concerned about screening mammograms, talk to your doctor and learn what’s right for you based on your individual risks. It’s important that the two of you work together to develop a screening plan.