This information is for women who are at average risk for breast cancer. If you don't know how high your risk is, talk to your doctor. He or she can help you find out. Sometimes women think that their risk is higher than it really is.
If you are at high risk for breast cancer, you may need to start mammograms at an earlier age.
A mammogram is an X-ray of the breast that is used to screen for breast cancer. Screening tests help your doctor look for a certain disease or condition before any symptoms appear. This can increase your chance of finding the problem at a more treatable stage. Often a mammogram can find tumors that are too small for you or your doctor to feel.
Experts have made great progress in treating breast cancer. If it is found early, breast cancer can often be cured, and it is not always necessary to remove the breast.
A mammogram is one of the most effective screening tools for breast cancer.
Studies show that mammograms can help reduce the number of breast cancer deaths in women ages 40 to 74.1
|Without mammograms||With mammograms|
|Ages 40-49||3.5 out of 1,000 women die of breast cancer||3 out of 1,000 women die of breast cancer|
|Ages 50-59||5.3 out of 1,000 women die of breast cancer||4.6 out of 1,000 women die of breast cancer|
Like other screening tests, mammograms aren't perfect. They have some limitations. For example, they may miss some cancers. This can delay treatment.
And there are some risks. Each time you have a mammogram, there is a risk that the test:
The more often you have mammograms, the more often you run the risk that the test will show something that looks like a tumor when it's not one or find cancers that will never cause a problem.
And the chance of having false-positive results is higher when you start having mammograms earlier. A study shows that the number of false-positives is almost twice as high for women who start having mammograms at age 40 as it is for those women who start at age 50.4
Mammograms may not work as well in women before menopause, because breast tissue in younger women is denser than in older women. The more dense the breast tissue, the harder it is to find a tumor.
You are briefly exposed to small amounts of radiation each time you have a mammogram. This exposure can add up over time. But the risk of damage to cells or tissue from being exposed to the level of radiation used for this test is low.
For women who are at average risk for breast cancer, there are no easy answers for when to start having mammograms. Even the experts don't agree on when is the best time to start.
But experts do agree that all women should start having mammograms by age 50.
In general, women younger than 50 are at a lower risk for breast cancer. The risk for breast cancer goes up as you get older.
|Age||Estimated risk over 10 years|
4 out of 1,000 women will get breast cancer
14 out of 1,000 women will get breast cancer
24 out of 1,000 women will get breast cancer
36 out of 1,000 women will get breast cancer
38 out of 1,000 women will get breast cancer
If you have certain risk factors that put you at increased risk for breast cancer, your doctor may suggest that you have a mammogram at a younger age. Women who have a personal or family history of breast cancer or who have inherited a BRCA1 or BRCA2 (say "BRAH-kuh") gene change are much more likely to get breast cancer.
When to start having mammograms is up to you. As you make your decision, here are some other things to think about:
Talk with your doctor about any questions or concerns you have about when to start screening. He or she can help you decide when to have your first mammogram and how often to have one.
|Start mammograms at age 40||Start mammograms at age 50|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"When I turned 40, I had my first mammogram. I had debated about when to start. Before deciding, I talked with my doctor about the pros and cons of starting early, especially since I wasn't at high risk for getting breast cancer. I know that some women, including my older sister, choose to wait until they're older. I guess when it came down to it, I just felt more comfortable starting sooner."
— Keiko, 41
"I'm not really worried about getting breast cancer, so I've decided to wait until I'm 50 to start having mammograms. I just turned 40, and I've always been healthy and active. Plus, I don't have any extra risk factors. I've seen the screening guidelines, and I've read that women in their 40s are more likely to have a false-positive test result. I don't need that kind of anxiety in my life! In the meantime, I'm going to check my breasts like I've always done, and continue to get regular checkups with my gynecologist."
— Helen, 40
"My friend was diagnosed with late-stage breast cancer after finding a lump in her breast when she was 48. She didn't have any risk factors for the disease, so she hadn't had any mammograms before then. I can't help but think that maybe if she'd had a mammogram a year or two before, the cancer may have been found earlier. I'm not at high risk for breast cancer either, but I'm going to keep having my yearly mammogram just to be sure nothing is wrong."
— Sally, 46
"I travel a lot for my job, and my days are often crammed with back-to-back meetings, so trying to schedule a mammogram every year is a challenge. But I've managed to get a mammogram every year, and they have all been normal. Now some doctors are saying that it's okay for women to wait and start having mammograms at 50. I think that's reasonable, and I don't feel like I would be putting myself at any greater risk for missing a cancer by waiting until I'm 50 to get my next one."
— Bella, 44
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to start mammograms at age 40
Reasons to start mammograms at age 50
I'm worried that I might get breast cancer at an earlier age.
I'm not too worried that I might get breast cancer at an earlier age.
I think starting mammograms earlier is worth the increased risk of having a false-positive test result if it could find cancer early.
I think the chance of having a false-positive test result is more likely than the test finding a real problem if I start having mammograms earlier.
I'm not afraid to have a biopsy or other tests if my doctor sees a problem on the mammogram.
I don't want to have a biopsy or other tests that I may not need.
I want to know if I have a breast cancer, even if it's a cancer that might never cause a problem.
I only want to know if I have a breast cancer that is going to be a problem.
I'm not afraid of being exposed to small doses of radiation each time I have a mammogram.
I don't want to be exposed to any more radiation than is necessary.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Start mammograms at age 40
Start mammograms at age 50
1. Does the risk of breast cancer go up as you get older?
2. Can mammograms help save lives?
3. Does a normal mammogram guarantee that breast cancer is not present?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||Kathleen Romito, MD - Family Medicine|
|Specialist Medical Reviewer||Kirtly Jones, MD - Obstetrics and Gynecology|
National Cancer Institute (2012). Breast cancer risk in American women. National Cancer Institute Fact Sheet. Available online: http://www.cancer.gov/cancertopics/factsheet/Detection/probability-breast-cancer.