Breast Cancer Screening Recommendations for You

There is powerful evidence for the effectiveness of breast cancer screening. Studies show that, since mammography (the most common breast cancer screening) became widespread in the 1980s, the United States breast cancer death rate in women dropped nearly 40% due to a combination of early detection through screening and improved treatments. Analysis of the data shows that at least 30% of this drop, and maybe as much as 60% of it, is due to mammograms. And yet, not everyone receives cancer screening care on time. Read below to learn more about cancer screening recommendations for you.

Teens and older
Know your breasts. From the time breasts develop, it’s wise to be aware of breast changes. A high-value comprehensive guide is available here.

Age 30 
If you don’t know, ask family members about their health history. Then work with your primary care provider to assess your risk. Based on family history and other factors, you may discover the need to have a mammogram earlier than is recommended for women of average risk.

Age 40
One in six breast cancers occurs in women in their 40s, and these cancers tend to be more aggressive than those found in older women. Approximately 75% of breast cancers occur in women who have no family history of the disease and are not high-risk, so the absence of a family history is not a reason to skip screening. If you are a woman aged 40 or older and have an average risk of breast cancer, the American College of Radiology and Society of Breast Imaging recommend that you begin getting a mammogram every year. Other organizations, such as the American Cancer Society, recommend that women screen  annually until age 55 but can then switch to screening every other year. Although the different guidelines can be confusing, all of them strongly encourage regular screening mammograms, and patients can discuss these guidelines and their risk with their healthcare provider to develop a screening plan that works for them.

Black women
For many reasons, research shows that black women get breast cancer earlier and are more profoundly affected than women in other ethnic groups. Breast cancer diagnosed before age 50 represents 23 percent of all breast cancers in black women, compared to only 16 percent of all breast cancers in white women. In addition, black women are twice as likely to be diagnosed with triple-negative breast cancer and 30% more likely to die from breast cancer. For these reasons, it is even more important for black women to be screened regularly and on time. Visit https://besure.bwhi.org/ for resources and information from black women for black women.

Transgender individuals
Sex assigned at birth, hormone use, and surgical histories place transgender people at increased risk for breast cancer. For instance, due to hormone use, biological males transitioning to female are at increased risk for breast cancer compared to other males. Biological females transitioning to male who do not undergo mastectomy remain at their previous risk for breast cancer. In addition, transgender males are less likely to have regular checkups or be routinely screened. A cancer guide for trans people is available here.   

Very high risk women
Women with certain genetic predisposition to breast cancer such as the BRCA gene may benefit from magnetic resonance imaging (MRI) screening which is often also used for monitoring high risk breast cancer after initial treatment.

Age 70 and beyond
Most organizations recommend that women think about stopping mammograms around age 80; although, there is no hard and fast rule. For example, the American College of Radiology and the Society of Breast Imaging recommend that women continue screening, unless severe comorbidities limit life expectancy. The American Cancer Society recommends that screening continues every other year as long as a woman is in good health and is expected to live at least 10 years.

Knowing more about the breast screening recommendations for you can help you make good health decisions, catch cancer early, limit disruptive and expensive breast cancer treatments, and save your life.

Natacha Jager, MD, is a family medicine physician at SVMC Northshire Campus in Manchester Center, VT. The practice is a part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care in Bennington.