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Breast Cancer Screening
The type and frequency of breast cancer screening that is best for you changes as you age.
- Ages 20 to 39: Some experts recommend that women have a clinical breast exam every 3 years, starting at age 20. Talk with your doctor about how often you should have a breast exam. If you have a high risk for developing breast cancer, talk to your doctor about when to begin having routine mammograms and other screening tests, such as magnetic resonance imaging (MRI).
Ages 40 and older: It is important for you to discuss with your doctor the medical evidence about mammograms before you decide when to start having mammograms and how often to have them. For woman at average risk:
- The U.S. Preventive Services Task Force recommends a screening mammogram every 2 years for women ages 50 to 74. For women ages 40 to 49, the balance of benefits and harms isn't as clear. Your doctor can help you understand the balance in your specific case. The Task Force says that the decision to start regular screening before age 50 should be an individual one. It should be based on a woman's values, her health history, and what she prefers.
- The American Cancer Society recommends that women start screening at age 45 with a mammogram every year until age 54. At age 55, women should switch to having a mammogram every 2 years. This can continue as long as their health is good and they are expected to live 10 or more years. The Society also states that women should have another option based on their values and preferences. This option is annual screening for women ages 40 to 44 and women ages 55 and older.
- The risk of breast cancer increases with age, and the age at which testing no longer helps reduce death from breast cancer is not known. If you are 75 or older, talk to your doctor about mammography as a regular part of your health care plan.
You can find out your personal risk level at www.cancer.gov/bcrisktool.
Early detection is an important factor in the success of breast cancer treatment. The earlier breast cancer is found, the more easily and successfully it can be treated. Tests used for screening include:
- Mammogram. A mammogram is an X-ray of the breast that can often find tumors that are too small for you or your doctor to feel. Standard mammograms use film to record images of the breast, but most mammograms done now are digital mammograms. Digital mammograms record images of the breast in an electronic file.
- Digital breast tomosynthesis (3-D mammogram). This test uses X-rays to create a three-dimensional image of the breast. This is a newer test that may be used alone or with a digital mammogram.
- Clinical breast exam (CBE). During a clinical breast exam, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes. Talk to your doctor about whether to have a clinical breast exam.
Make sure you know what your breasts normally look and feel like. When you know what is normal for you, you are better able to notice changes. Tell your doctor right away if you notice any changes in your breasts.
Magnetic resonance imaging (MRI) of the breast may be used as a screening test for women who have a high risk of breast cancer. This includes women who test positive for the BRCA1 or BRCA2 gene, or have two or more close family members who have had breast cancer before age 50. MRI may also be useful for women who have breast implants or for women whose breast tissue is very dense.
Your breast density can affect how clearly your breast tissue can be seen on a mammogram. Still, if you have dense breasts and if nothing else increases your risk for breast cancer, a mammogram is the recommended test for you.
For more information, see the topic Breast Cancer.
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Other Works Consulted
- American College of Obstetricians and Gynecologists (2011). Breast cancer screening. ACOG Practice Bulletin No. 122. Obstetrics and Gynecology, 118: 372–382.
- Oeffinger KC, et al. (2015). Breast cancer screening for women at average risk 2015 guideline update from the American Cancer Society. JAMA, 314(15): 1599–1614. DOI: 10.1001/jama.2015.12783. Accessed January 21, 2016.
- Siu AL, U.S. Preventive Services Task Force (2016). Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, published online January 12, 2016. DOI: 10.7326/M15-2886. Accessed January 12, 2016.
Current as of: August 22, 2019
Author: Healthwise Staff
Sarah Marshall MD - Family Medicine
Kathleen Romito MD - Family Medicine
Douglas A. Stewart MD - Medical Oncology
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