Headed toward your 40th birthday? Your OB/GYN or another women’s health provider may have recommended you begin routine mammograms at that age. But why is that?
You probably know the basics: Screening mammograms are used to diagnose breast cancer. Beyond that, though, things may be a little fuzzy. If you’re more than a little confused about who needs mammograms and when, you aren’t alone!
In the last two decades, guidelines about mammography seem to change all the time and different organizations have different recommendations. That can make it challenging to know what’s what.
The most important thing to know is that having regular mammograms is a vital part of routine women’s health care. Your medical provider can offer you specific guidance about when you should have your first mammogram and how often you need to be screened, as well as whether other types of breast cancer screening may be needed.
In the meantime, let’s clear up the details about what’s recommended and why. Keep reading to learn more.
What the guidelines say
There are many different sets of guidelines related to mammograms, and as we mentioned earlier, they change every so often. Which ones should you pay attention to? The American College of Radiology (ACR) guidelines are a good starting point.
The ACR has long recommended that annual mammograms begin at age 40 for women at average risk of breast cancer, but in May of this year, they added a new recommendation that women undergo a breast cancer risk assessment by age 25 to determine if earlier screening may be needed.
That recommendation pertains to all women, but the ACR specifically mentions that Black and Ashkenazi Jewish women should have this risk assessment. That’s because breast cancer incidence rates are higher among those women and cancer is more likely to be diagnosed at a later stage, when it’s less treatable.
So, what’s right for you? Your provider can help you determine what’s best for your specific health needs, based on your risk factors, family medical history, and lifestyle.
Why the ‘routine’ part is so important
We’ve established that routine mammograms are universally recommended as part of routine health care for women, but why is it so important that women be screened regularly?
When you undergo a mammogram, the screening technologist is capturing detailed X-ray images of your breast tissue. These images are then reviewed by a specialty-trained radiologist, who looks for any signs of abnormalities in the breasts.
The images are detailed and refined enough to draw attention to tiny breast irregularities that may not otherwise be detectable. Breast cancer found at that stage is much more treatable than cancer found at a later stage, such as after a lump is detected by a woman or her provider.
The risk of developing breast cancer increases as women get older, which is why breast cancer screening is recommended beginning in a woman’s 40s. Routine mammograms, meaning screenings scheduled at regular intervals, play a key role in ensuring that breast cancer doesn’t develop and grow substantially between screenings.
Even an extra year between mammograms can make a big difference. A 2019 study found that women who were diagnosed with breast cancer after undergoing annual mammograms were diagnosed at an earlier stage, when the cancer was smaller and less advanced, than women who had mammograms every two years.
Breast cancer detected at an early stage, when the cancer is still localized, has a five-year survival rate of 99%. Routine mammograms are essential for finding breast cancer in that stage.
Other things to know about breast cancer screenings
Mammograms are the recommended method of breast cancer screening for women at average risk of developing the disease, but some women may benefit from earlier or more frequent screening or from the addition of other screening methods.
The ACR notes that women who have a greater-than-average risk may need to begin screenings as early as age 25. Risk factors for breast cancer include:
- Being of certain races or ethnicities, including Black and Ashkenazi Jewish
- Having a family history of breast cancer
- Having a personal history of breast cancer
- Having certain genetic mutations
- Having dense breasts
- Having undergone past chest radiation
Along with earlier screening, the ACR also recommends that women with a higher risk of developing breast cancer have breast MRIs in addition to annual mammograms. This includes women who were diagnosed with breast cancer prior to age 50, those who have a history of breast cancer, and those who have dense breasts.
Note that they recommend having an MRI in addition to an annual mammogram, not in lieu of a mammogram. That’s especially important for women who have dense breasts.
Dense breasts are made up of a larger proportion of fibrous and glandular tissue, which appears as white on a mammogram, the same as a cancerous tumor. That can make it harder to detect cancer using a mammogram alone. Having dual screenings provides a double layer of protection.
For women at a higher risk who can’t undergo MRI screening, the ACR recommends contrast-enhanced mammography, which uses contrast dye to enhance mammography images.
The bottom line about routine mammograms
Still a little confused about whether you need to schedule a mammogram? Every woman is unique—and so are her risk factors! The decision about when to begin mammograms and how often to have them is best made with a medical provider who knows your specific needs.
Your women’s health provider will consider your overall health and your risk factors when making a personalized recommendation for you. The most important thing is that you have routine mammograms, because they can truly be lifesaving.
Learn More
Due for a mammogram? Scheduling one is easy! Request an appointment using our online form, or call 770-219-7666.