At what age should women start getting mammogram (mammography) screenings?

From the Guidelines

Women should start getting mammogram screenings at age 40, as annual screening mammography in this age group decreases breast cancer mortality by 15% to 50%. The American College of Radiology recommends annual screening mammography starting at age 40 in average-risk women 1. This recommendation is supported by a 2024 study published in the Journal of the American College of Radiology, which found that annual screening mammography in women 40 to 49 years of age saves 42% more lives and life-years than biennial screening due to faster growing tumors in younger women 1.

Some key points to consider:

• Women with higher risk factors, such as a family history of breast cancer, genetic mutations like BRCA1 or BRCA2, or previous radiation therapy to the chest, may need to begin screening earlier, typically around age 30 1.
• The screening involves a low-dose X-ray of the breast to detect abnormalities before they can be felt.
• Mammograms are important because they can detect breast cancer in its early stages when treatment is most effective and survival rates are highest.
• The benefit of early detection through regular mammography increases with age, as breast cancer risk rises as women get older.
• Women should discuss their personal risk factors with their healthcare provider to determine the most appropriate age to begin screening and the recommended frequency.

It's worth noting that while some guidelines suggest starting screening at age 45 or 50, the most recent and highest-quality evidence supports starting at age 40 1. Additionally, women who have had breast surgery for cancer or benign lesions should continue to undergo regular screening mammography as long as they remain in overall good health and are willing to undergo the examination and subsequent testing or biopsy, if an abnormality is identified 1.

From the Research

Mammogram Screening Ages

• The American College of Radiology (ACR) recommends annual screening beginning at age 40 for women of average risk 2, 3.
• For women at higher-than-average risk, the ACR recommends earlier and/or more intensive screening, with MRI surveillance starting at ages 25 to 30 and annual mammography starting at a variable age between 25 and 40, depending on the type of risk 2.
• The European Commission Initiative on Breast Cancer (ECIBC) suggests that the balance between benefits and harms of different screening intervals is still a matter of debate, but biennial screening may be favored in women 50-69 years old 4.
• A systematic review of global guidelines for breast cancer screening found that most guidelines recommend mammographic screening for average-risk women aged 40-74 years, with annual or biennial screening intervals 5.
• Women with a family history of breast cancer, genetic predisposition, or other risk factors may benefit from earlier and more frequent screening, including annual MRI or mammography starting at a younger age 2, 5, 6.

Screening Intervals and Risk Factors

• Annual screening is recommended for women who wish to maximize benefit, starting at age 40 years, and continuing without an upper age limit unless severe comorbidities limit life expectancy 3.
• Women with dense breasts, personal histories of breast cancer, or atypia at biopsy may benefit from supplemental screening with MRI or other modalities 2.
• Risk factors for breast cancer, including family history, genetic predisposition, and personal history of pre-cancerous lesions or breast cancer, should be assessed and considered when determining screening intervals and modalities 2, 5, 6.