Experts Recommend Screening Mammograms Beginning at Age 40

By Steve Blanchard - October 20, 2023

Continue to get your mammogram annually. That’s the message from the American College of Radiology’s Society of Breast Imaging and the National Comprehensive Cancer Network.

“All women, regardless of race, should begin getting annual mammograms no later than age 40,” said Dr. Bethany Niell, section chief of breast imaging at Moffitt Cancer Center. “Women at increased risk may need to begin breast cancer screening exams as early as age 25. Our goal is to decrease deaths from breast cancer. To save the most lives, mammograms should be done every year, not every other year, and mammograms should start at age 40, not 50.”

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"To save the most lives, mammograms should be done every year, not every other year, and mammograms should start at age 40, not 50."

- Dr. Bethany Niell, Diagnostic Imaging and Interventional Radiology Program

Earlier this year, the United States Preventive Services Task Force issued new draft guidelines for breast cancer screenings every other year starting at age 40. It’s an improvement upon previous recommendations, which suggested screenings beginning at age 50, Niell said. Annual screenings beginning at 40 will save more lives.

Delaying those screenings could also contribute to health disparities in the Black and African American community, according to Niell.

“Beginning screening at age 50 as previously recommended by the task force results in fewer lives saved,” Niell said. “This is especially detrimental to Black women because they are more likely to be diagnosed with breast cancer at a younger age.”

Some important factors to consider:

  • Prior to age 50, minority women are 127% more likely to die of breast cancer; 72% more likely to be diagnosed with breast cancer; and 58% more likely to be diagnosed with advanced stage breast cancer.
  • Black women are 42% more likely to die from breast cancer despite roughly equal incidence rates.
  • Black women are less likely to be diagnosed with early stage breast cancer but twice as likely to die of early breast cancers.
  • Black women have a two-fold higher risk of aggressive — “triple-negative” — breast tumors and a higher risk of BRCA1 and BRCA2 genetic mutations (placing them at higher risk).

Knowing your risk is key to your screening, Niell said.

“If you have risk factors for breast cancer, these guidelines do not apply to you,” Niell said. “It’s really important that each of us understands our cancer risk factors.”

All individuals should undergo a risk assessment by age 25. If they are found to be at increased risk, they may be eligible for earlier screening with mammograms and MRIs.

Transgender individuals should also consider themselves at potentially increased risk, according to Niell.

“Transgender people who use hormones and/or have had surgeries may be at increased risk of breast cancer,” Niell said. “They should follow separate guidelines based upon their risk factors.”

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