At what age should mammography (mammogram) screening start and stop?

From the Guidelines

Mammography Screening Guidelines

Women with an average risk of breast cancer should start mammogram screening at age 40 and continue annually until age 55 1, 2. After age 55, screening can be done every other year, or women can choose to continue annual screening.

Stopping Routine Mammogram Screening

Women should stop routine mammogram screening at age 75, or when life expectancy is less than 10 years 3, 4, 5. However, these guidelines may vary for women with a higher risk of breast cancer, such as those with a family history or genetic mutations, who may need to start screening earlier and continue more frequently.

Key Considerations

• Annual screening is recommended for women aged 40-55 years, with the option to continue annual screening after age 55 1.
• Biennial screening is an acceptable option for women who receive screening, but may not be suitable for women with dense breasts or other high-risk factors 3.
• Shared decision-making is essential for women to discuss their individual risk factors and screening schedule with their healthcare provider 2, 4, 5.
• Life expectancy and overall health should be considered when deciding to continue or discontinue screening mammography, rather than age alone 1, 3, 4, 5.

From the Research

Mammography Screening Age Recommendations

• The American College of Radiology (ACR) recommends annual screening beginning at age 40 for women of average risk 6, 7.
• For women at higher-than-average risk, the ACR recommends earlier and/or more intensive screening, with some women starting as early as age 25 6.
• The U.S. Preventive Services Task Force (USPSTF) and American Academy of Family Physicians (AAFP) recommend biennial screening mammography for average-risk women 50 to 74 years of age, but suggest individualized decision-making for women 40 to 49 years of age 8, 9.
• There is no strong evidence supporting a net benefit of mammography screening in average-risk women 40 to 49 years of age 9, 10.

Screening Continuation

• The ACR and Society of Breast Imaging recommend that screening continue past age 74 years, without an upper age limit, unless severe comorbidities limit life expectancy 7.
• The American College of Obstetricians and Gynecologists and the American Cancer Society state that screening may continue for women 75 years and older, depending on the woman's health status and life expectancy 9.

Special Considerations

• Women with dense breasts may benefit from supplemental screening, such as breast MRI or ultrasound 6, 9.
• Women at high risk of breast cancer may benefit from mammography starting at 30 years of age or earlier, with supplemental screening such as magnetic resonance imaging 6, 9.