If you’re a woman approaching 40, you may wonder if it’s time to schedule a mammogram. With recommendations varying between organizations, it can feel difficult to determine what’s best for you.
Screening guidelines have changed in recent years, resulting in uncertainty for some women. For October’s Breast Cancer Awareness Month, health care providers want to ensure women feel confident in navigating their need for screening.
Breaking Down the Recommendations
“Essentially, we all agree that we should start mammograms at age 40, but there are some minor opinion differences on the interval,” says Dr. Annie Zeug, a General Surgeon specializing in breast surgery. “It’s important to talk to your doctor about your risks of developing the disease.”
Your doctor can help you determine your best guideline for the frequency of your mammograms, she adds. Depending on your risk factors and history, they also may recommend additional screening.
U.S. Preventive Services Task Force
For average-risk women, the newly updated U.S. Preventive Services Task Force guidelines recommend starting screening mammography at age 40 and continuing every other year. This is a change from the organization’s previous recommendations for average risk women beginning screenings at age 50.
The updated recommendations came in April 2024 to address the rising incidence of cancer overall in younger people. In addition, breast cancer diagnoses have been in increasing in younger women since 2015.
American Cancer Society
The American Cancer Society recommendation differs slightly. It recommends annual screening beginning at age 45. Women should have the option to start as early as age 40, depending on risk, the group states. Women ages 55 and older may choose to switch to screening every other year or continue yearly mammograms.
Other Recommendations
The American Society of Breast Surgeons recommends yearly mammograms starting at age 40, while the American College of Obstetrics and Gynecology recommends women have a mammogram every one to two years starting at age 40.
“The most all-encompassing recommendation would be starting at age 40, every one to two years based on shared decision-making with the woman and her care team,” Dr. Zeug says. “Your discussion with your health care provider should take into account your circumstances and risk level.”
Importance of Mammograms
“Getting a mammogram is often the best way to find breast cancer early, when it’s most treatable,” according to Breastcancer.org. “A mammogram can detect breast cancer before any symptoms develop. It can detect a tumor that cannot be felt. Some studies have shown that having regular mammograms can lower your risk of dying from breast cancer.”
A mammogram uses X-rays to help detect any abnormalities in the breast tissue. During the exam, a technologist will compress the breast between surfaces to provide a clear picture.
Other Factors to Consider
If you’re at higher risk for developing breast cancer, The American Cancer Society recommends MRI screening and mammograms, typically starting at about age 30.
Factors that would place you at higher risk including having a BRCA1 or BRCA2 gene mutation, having a first-degree relative with the gene mutation, or having a first-degree relative who developed breast cancer.
Other conditions also affect risk. These include undergoing radiation treatment to the chest before age 30 and having dense breast tissue. Your primary care physician or OB-GYN will help you assess your personal risk.
Risk in Certain Groups
It’s also important to understand that Black women have an increased risk for developing aggressive triple-negative breast cancer. This means the cancer cells do not have estrogen or progesterone receptors or the protein HER2, and are more difficult to treat.
Black women are more likely to die from breast cancer than white women, even for the most treatable types. They have a 40% higher mortality rate than white women. The American Cancer Society points to racial disparities in high-quality screening and timely treatment as key factors.
Women in their 40s and younger also have special considerations.
“Younger women are at lower risk of developing breast cancer. However, women ages 40 to 49 often develop a more aggressive type of cancer,” Dr. Zeug says. “Early detection is paramount in improving life expectancy.”
What’s at Stake
While death rates for breast cancer have fallen, it’s still the second-most common cancer death for women. In 2024, the American Cancer Society expects the diagnosis about 56,500 cases of ductal carcinoma in situ — a pre-invasive type of breast cancer, also called Stage 0. The group projects more than 310,000 new cases of invasive breast cancer and over 42,000 breast cancer deaths.
“The key takeaway is having discussions with your care team about your risks and continuing regular screenings,” Dr. Zeug says. “We want women to feel empowered in taking care of their health.”
