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Breast Cancer Screening Guidelines

All women should know about their breast cancer risk — a factor that varies with age and family history. Learn about when, how and why to get screened.

woman getting mammogram
Pre-COVID photo. Mammography is an important tool for detecting breast cancer early.

Different health care organizations have adjusted their recommendations for breast cancer screening in recent years. That has led to confusion about whether annual mammograms are necessary for women over 40 — and whether women should do self-exams of their breasts.

Although guidelines may vary, all doctors agree that mammograms can be lifesaving. The risk of not screening is greater than a false positive result. A false positive may cause temporary anxiety but having breast cancer go undetected is much worse.

Screening guidelines for breast cancer vary depending on your age, family history and other risk factors, such as genetic links to cancer.

The Rogel Cancer Center follows guidelines set by the National Comprehensive Cancer Network (NCCN), which recommends the following steps for women with average risk.

Breast cancer screening for average-risk women

Women ages 25 to 39

  • Have a breast exam by your doctor every one to three years
  • Pay attention to any changes to your breasts
  • Ask your doctor for a breast cancer risk assessment

Women 40 and older

  • Have a breast exam by your doctor every year
  • Pay attention to any changes to your breasts
  • Ask your doctor for an ongoing breast cancer risk assessment
  • Have a screening mammogram annually

The NCCN has long recommended annual mammograms for women 40 and older because this saves the most lives of patients with breast cancer and gains the most life years for patients who have been treated.

Even though women are more likely to get breast cancer as they age, 20 percent of our breast cancer patients are diagnosed under the age of 50. Breast cancers that are found early with screening mammography have higher rates of survival.

There is no specific upper age limit for healthy women to have a screening mammogram. According to the American Cancer Society, screening should continue as long as a woman is in good health and is expected to live 10 years or longer.

Breast cancer screening for high-risk women

Women at high risk of breast cancer, such as those with a family history, should have additional surveillance. NCCN guidelines for women with high breast cancer risk advise the following.

Women 35 and older

  • Have a breast exam by your doctor every six to 12 months
  • Pay attention to any changes to your breasts
  • Ask your doctor for risk-reduction strategies
  • See a genetic counselor to identify any genetic links to cancer
  • Have a mammogram annually
  • Consider a 3D mammogram, called tomosynthesis

Women with a lifetime breast cancer risk higher than 20 percent should follow all of the guidelines above and have an annual breast MRI.

Tests that screen for breast cancer

Several tests and imaging techniques are used to screen for or detect breast cancer:

  • Mammogram: An X-ray image of your breast to find abnormalities such as masses and other signs of cancer.
  • Tomosynthesis: An advanced three-dimensional mammogram that studies breast tissue in “slices” and may help detect cancer in women with dense breast tissue.
  • Ultrasound: Used to determine whether a mass is solid or filled with fluid. Cancer is solid, though not all solid masses are cancerous.
  • Magnetic resonance imaging (MRI): Creates a full image of your breast by combining images from many angles. Used mostly in high-risk patients or to provide more information after cancer has been detected.

Schedule a mammogram at Michigan Medicine. For more information, call the Cancer AnswerLine™ at 800-865-1125.

Check out our Cancer Doesn’t Wait for COVID series:


What You Need to Know About the COVID Vaccine and Mammograms

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