This article reviews the different guidelines for a mammogram to screen for breast cancer. You should discuss these with a healthcare provider to determine what schedule is right for you.
Women Ages 40 to 49
For women with an average risk of breast cancer, the American Cancer Society (ACS) recommends yearly screening for breast cancer with mammograms starting at age 45, with the option to begin at age 40.
The American College of Obstetricians and Gynecologists (ACOG) recommends that women with an average risk of breast cancer get mammograms yearly or every other year starting at age 40.
But not all health authorities recommend screening for this age group. The American College of Physicians says women of average risk from age 40 to 49 should discuss screening mammography with their healthcare provider since the potential harms may outweigh the potential benefits.
The U.S. Preventive Services Task Force (USPSTF) 2016 guidelines do not recommend screening mammograms at younger than age 50 for women of average risk but say it is an individual decision for women aged 40 to 49. The American Academy of Family Physicians (AAFP) supports the USPSTF guidelines.
Women Ages 50 to 69
According to ACOG, women should start having yearly or every other year mammograms by age 50 at the latest. The ACS says that women who are 55 and older can continue to have yearly mammograms or switch to mammograms every other year for breast cancer screening.
The ACS has criteria for determining high risk, and this includes factors such as a family history of breast cancer, a known genetic mutation that increases the risk of breast cancer, a history of radiation to the chest between age 10 and 30, or other risk factors.
The American College of Physicians notes that yearly breast cancer screening is not better than every-other-year breast cancer screening in terms of life expectancy.
The USPSTF recommends biennial (every two years) mammography for women aged 50 to 74. However, its 2016 guidelines are being updated, and changes may be made in 2022 or after. AAFP supports the USPSTF guidelines.
Women Ages 70 and Older
ACOG recommends that women at average risk of developing breast cancer should have a yearly or every-other-year screening mammogram until age 75. USPSTF recommends mammograms every two years, ending at age 74. AAFP supports the USPSTF guidelines.
At this time, a mammogram is the recommended screening tool for breast cancer for women who have dense breasts.
According to the ACS and ACP, women should continue regular breast cancer screening with mammograms if they are in good health and expected to live at least 10 more years. This is because screening mammogram is expected to detect early-stage breast cancer and prolongs life expectancy by an average of 11 years.
However, men who have had a personal history of breast cancer or who have a high risk of developing breast cancer may need periodic screening with a mammogram or other imaging test (such as a chest MRI or ultrasound) to monitor for signs of recurrent or new breast cancer.
Guidelines for Transgender People
Transgender people may be at risk of developing breast cancer and may need screening mammography, depending on hormone exposure and whether there is any breast tissue.
Recommendations from the American College of Radiology include:
For transfeminine individuals (male to female) who have used hormone therapy, breast cancer screening with a mammogram or digital breast tomosynthesis (DBT, also called 3D mammography) may be recommended. For transmasculine individuals (female to male) who have not had full breast removal, breast cancer screening with a mammogram is recommended. Breast cancer screening is not recommended for transmasculine individuals who have had a bilateral mastectomy (complete removal of both breasts).
Summary
Mammograms are recommended as a standard breast cancer screening test for women of average breast cancer risk aged 40 and older, although some health authorities recommend not starting screening until 50. The recommended frequency is every year or every other year until 75 but may continue if the person has a life expectancy of 10 years or more.
According to the American Cancer Society, women who are at a high risk of breast cancer need to begin having yearly mammograms, as well as breast MRIs, at age 30. If you are high risk, discuss with your healthcare provider the best time to start screening. You should have this conversation even if you are under 25.
Dense breasts, a common variation, increase the risk of breast cancer, and dense breasts also make mammography testing less sensitive for breast cancer. However, at the current time, a mammogram is recommended as the best screening test for women who have dense breasts.
Transgender individuals who have breast tissue or who have taken feminizing hormones such as estrogen should have mammography screening for breast cancer.
Breast cancer screening is not generally recommended for men, but men who have a high risk of breast cancer may need to have regularly scheduled mammograms for breast cancer screening.
A Word From Verywell
Preventive health care is a powerful tool that can save your life. This includes having yearly or every other year mammograms if you are a woman with an average risk of breast cancer. You might need a different schedule or additional testing if you have a higher-than-average risk of breast cancer.
Sometimes you are asked to stay for additional images if the technician or the radiologist notices an area that requires further evaluation. It’s always a good idea to ask the staff how long you should expect your test to take.
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