From the Guidelines
A 38-year-old woman can have a mammogram, but it is not typically recommended as a routine screening for women at average risk of breast cancer until age 40. According to the American Cancer Society guidelines 1, women should undergo clinical breast examination every 3 years between the ages of 20 to 39 years, and annually after age 40 years. However, women in their 30s may receive mammograms in certain situations, such as having a family history of breast cancer, carrying genetic mutations like BRCA1 or BRCA2, having a personal history of breast cancer, or experiencing concerning breast symptoms. The USPSTF also recommends screening mammography every one to two years for women aged 40 and older 1.
Some key points to consider:
- The American Cancer Society recommends that average-risk women should begin annual mammography at the age of 40 years 1.
- Women at significantly increased risk for breast cancer may benefit from earlier initiation of screening, screening at shorter intervals, and the screening with additional modalities such as ultrasound or magnetic resonance imaging 1.
- The USPSTF found fair evidence that mammography screening every 12 to 33 months significantly reduces mortality from breast cancer, with the strongest evidence for women aged 50 to 69 1.
- Women concerned about their breast cancer risk should discuss their personal risk factors with their healthcare provider to determine the appropriate age to begin mammography screening.
It's essential to weigh the benefits and potential harms of mammography screening, including false positives, biopsy for abnormalities that prove to be benign, and the short period of anxiety that naturally would accompany a period where there was uncertainty about the presence of a malignancy 1. Ultimately, the decision to have a mammogram at 38 years old should be individualized, considering the woman's overall health status, risk factors, and anticipated longevity.
From the Research
Mammography Screening for a 38-Year-Old Woman
- The American College of Radiology (ACR) and the Society of Breast Imaging recommend annual mammography screening beginning at age 40, as it provides the greatest mortality reduction, diagnosis at an earlier stage, better surgical options, and more effective chemotherapy 2.
- However, there is evidence to suggest that screening mammography can be beneficial for women in their 40s, with a reduction in breast cancer mortality, years of life lost to breast cancer, and morbidity of breast cancer treatment by detecting cancers at an earlier stage 3, 4.
- For women at high risk for hereditary breast cancer, such as those with BRCA1 or BRCA2 mutations, magnetic resonance imaging (MRI) may be more sensitive for detecting breast cancers than mammography, ultrasound, or clinical breast examination alone 5, 6.
- While there is no direct evidence to support mammography screening for a 38-year-old woman, some studies suggest that the benefits of screening may outweigh the risks for women in their 40s, and that annual screening starting at age 40 may provide the greatest benefit 2, 3, 4.
- It is essential to consider individual risk factors and discuss the benefits and risks of mammography screening with a healthcare provider to determine the best course of action.