Breast Cancer Screening: When to Get a Mammogram
Learn when to start mammograms based on age and risk
Learn when to start mammograms based on age and risk
Key Takeaways
- Start mammograms between ages 40 and 45.
- Discuss your personal risk with your doctor.
- Higher-risk women may need earlier screening.
- Do not wait to report new breast symptoms.
Wondering when to get a mammogram? Knowing when to start screening can make a difference.
Breast cancer screening can detect changes before a lump or other symptoms appear, when treatment may be more effective.
Scripps recommends that women at average risk begin mammograms between ages 40 and 45.
Your primary care physician can help determine when to start and how often to get screened based on your health history and breast cancer risk. They can also evaluate breast changes, explain mammogram results and coordinate follow-up care when needed.
“Primary care is often where conversations about breast cancer screening begin,” says Sally Williams, MD, an internal medicine physician at Scripps Clinic Torrey Pines. “Talking with your doctor can help you make informed decisions based on individual risk factors and health needs.”
Here is what to know about mammograms:
1. Mammograms can help detect breast cancer early
A screening mammogram uses low-dose X-rays to look for changes in the breast before symptoms develop.
Early detection is especially important because breast cancer is common. About 1 in 8 women in the United States will develop breast cancer during their lifetime.
In 2026, an estimated:
- 321,910 new cases of invasive breast cancer will be diagnosed in women
- 60,730 cases of ductal carcinoma in situ (DCIS) will be diagnosed in women
DCIS occurs when abnormal cells are confined to a breast milk duct and have not spread into surrounding breast tissue. Often called stage 0 or noninvasive breast cancer, DCIS is most commonly detected during a routine mammogram.
Breast cancer death rates have declined in recent decades, thanks in part to earlier detection and advances in treatment.
2. Screening matters even without a family history
Breast cancer screening is important even if the disease does not run in your family. Most women who develop breast cancer do not have a strong family history.
A woman is generally considered at average risk for breast cancer if she does not have:
- A personal history of breast cancer
- A strong family history of breast cancer
- A known inherited gene variant linked to breast cancer
- A history of radiation therapy to the chest before age 30
“Family history is only one part of breast cancer risk,” Dr. Williams says. “Age, breast density and other factors also matter, so women should not skip screening simply because breast cancer does not run in their family.”
Tell your doctor about any breast, ovarian, pancreatic or prostate cancer on either side of your family, especially cancers diagnosed at a younger age. Also share any previous breast biopsies, abnormal imaging results, medications or hormone use.
Based on your personal history, your doctor may recommend a formal risk assessment, genetic counseling or a consultation with a breast specialist.
3. Don’t wait for a routine mammogram if you have symptoms
Routine screening schedules are intended for women who do not have breast symptoms. Contact your doctor right away if you notice:
- A new lump or thickened area
- Nipple discharge, especially bloody discharge
- A newly inverted nipple
- Skin dimpling, redness or thickening
- A change in breast size or shape
- Persistent breast or nipple pain
- Any other new or unusual breast change
Your doctor can examine the area and order diagnostic imaging or a refer you to a specialist if needed. “A new symptom should be evaluated even if your most recent mammogram was normal,” Dr. Williams says. “Do not wait for your next screening mammogram.”
4. Some women need earlier or additional screening
Women at higher-than-average risk may need to start screening before age 40, have mammograms more often or add breast MRI to their screening plan.
Factors that may affect screening recommendations include:
- A BRCA1, BRCA2 or another inherited gene variant linked to breast cancer
- A strong family history of breast cancer
- A lifetime breast cancer risk of about 20% or greater, based mainly on family history
- Radiation therapy to the chest before age 30
- A personal history of breast cancer
- Certain high-risk breast conditions found during a biopsy
5. Mammograms have benefits and limitations
Mammograms use very low doses of radiation and the benefits of finding breast cancer early generally outweigh the potential risk.
During the exam, each breast is compressed between two plates to produce clear images. Tell the technologist if you are uncomfortable so they can adjust your positioning.
Mammograms do not find every breast cancer and can produce false-positive results, meaning follow-up testing shows that an abnormal area is not cancer.
A callback does not necessarily mean you have breast cancer. A radiologist may recommend additional testing, such as a diagnostic mammogram or ultrasound.
6. 3D mammography provides more detailed breast images
Digital breast tomosynthesis, also called 3D mammography, takes multiple low-dose X-ray images of the breast from different angles and combines them into detailed views of breast tissue.
Compared with standard 2D mammography, it may help radiologists see some breast cancers more clearly and reduce callbacks for additional imaging. Both methods are accepted for breast cancer screening.
Scripps offers 3D mammography at select locations.
7. Dense breasts may affect your screening plan
Dense breasts contain more fibrous and glandular tissue and less fatty tissue. This can make cancer more difficult to detect on a mammogram. Dense breast tissue is also associated with a higher risk of developing breast cancer.
“Having dense breasts does not automatically mean you need additional imaging,” Dr. Williams says. “Your doctor will consider your breast density along with your age, family history and other risk factors.”
Based on your overall breast cancer risk, your doctor may recommend 3D mammography, breast ultrasound or breast MRI. Supplemental ultrasound or breast MRI is not recommended for every woman with dense breasts because it can lead to additional testing and biopsies that show no cancer.
Women with breast implants generally follow the same age- and risk-based screening recommendations. Tell the imaging center about your implants when scheduling your mammogram as additional views may be needed.
8. Check your insurance coverage before a mammogram
Most health plans subject to Affordable Care Act preventive-service requirements cover recommended in-network screening mammograms without a copayment, coinsurance or deductible. Additional imaging or pathology services needed to complete the screening process also may be covered without cost sharing.
Coverage may vary for tests used to evaluate a breast lump or other symptom, out-of-network care and services not considered part of preventive screening.
Before your appointment:
- Confirm that the imaging center is in your health plan's network
- Ask whether the exam will be billed as screening or diagnostic
- Check coverage for 3D mammography and follow-up imaging
- Ask about possible out-of-pocket costs
Scripps provides mammography services at multiple locations throughout San Diego County. Free breast cancer screening and diagnostic services are available through the Every Woman Counts program for eligible California residents with low-income who are uninsured or underinsured. Call 800-511-2300 to learn if you qualify.