Understanding the Mammogram Screening Guidelines

by Paul Goldfarb, MD, surgical oncologist

Learn about the changes in breast cancer screening and mammography recommendations.

You’ve probably heard the chatter on morning radio, read the headlines and even discussed it with your friends — why are breast mammogram screenings so controversial?

You may wonder how something that’s proven to save lives can possibly be controversial. At the heart of the debate is the issue of when to get screened and how often.

When it comes to matters of your health and your life, you want to make the best decision possible. But figuring out what to do about your mammograms can be a challenge when even the experts don’t seem to agree.

At Scripps, we recommend that women begin mammograms at age 40, which is the established gold standard recommendation.

Mammogram screening recommendations

Two of the most highly-regarded national health organizations have different recommendations for women who have an average risk of developing breast cancer.

Start screenings:
Get Screened:
American Cancer Society (ACS)
Age 45
Every year until doctor says to stop
U.S. Preventive Services Task Force
Age 50
Every other year until age 74

Why the difference in mammogram screening recommendations?

Your odds of being diagnosed with breast cancer increase as you get older. The National Cancer Institute estimates that 1 out of every 28 women in their 60s will develop breast cancer. For women in their 40s, the odds are 1 out of 68.

Because the risk of breast cancer is lower in younger women — and because some studies suggest that mammography only slightly reduces the risk of a woman in her 40s dying from breast cancer — the Task Force suggests that women in their 40s talk to their doctors about when to start screenings and how often to get them.

It’s not that the Task Force is against mammography for women in their 40s. In fact, the organization acknowledges that screenings are effective for this age group. Rather, the Task Force wants you to make an informed decision with your doctor based on your personal risk factors.

For women who are high-risk

Both the ACS and the Task Force agree that women who have a high risk of developing breast cancer need mammograms at least annually, and possibly other screenings such as magnetic resonance imaging (MRI).

You’re considered high risk for breast cancer if you have:

  • A first-degree relative (mother, sister, daughter) diagnosed with breast cancer, especially before age 45
  • A first-degree relative diagnosed with a breast cancer gene mutation, such as BRCA1 or BRCA2
  • A known breast cancer gene mutation, such as BRCA1 or BRCA2
  • A previous history of radiation treatment to your chest

This Scripps Health and Wellness tip was provided by Paul Goldfarb, MD, a surgical oncologist at Scripps Mercy. Learn more about breast care at Scripps.