Abstract
Correction: Updated Breast Cancer Screening Guidelines Patient Education Handout
The relevant guidelines were updated after the PEH’s acceptance for publication. We apologize for this oversight.
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Breast cancer is a very common type of cancer, and it is the second leading cause of cancer death for women in the United States. For Black and Hispanic women, it is the leading cause of cancer death. Screening means getting checked for cancer before you have any signs or symptoms. An early finding of cancer, often through an X-ray called a mammogram, saves lives. It usually means less aggressive treatment and a higher chance of survival.
A mammogram is an X-ray of the breast. It is currently the best way to find breast cancer for most women.
KNOW YOUR PERSONAL RISK
Your personal risk helps you and your doctor decide when and how often you need to be checked. It is recommended that all women talk to their doctor about their breast cancer risk by age 25. This is especially important for Black women and those of Ashkenazi Jewish descent.
WHY EARLIER SCREENING MATTERS FOR BLACK WOMEN
Black women are about 40% more likely to die from breast cancer than white women. They are also more likely to be diagnosed with aggressive cancer at younger ages. Starting mammograms at age 40 is expected to be especially helpful for Black women.
HIGH RISK
You are considered high risk if you have certain factors. This usually means you need to start screening earlier than age 40.
You have a calculated lifetime risk of 20% or more.
You have genetic changes linked to high cancer risk (like BRCA1 or BRCA2).
You have a personal history of breast cancer or a serious high-risk finding on a previous breast biopsy.
You had high-dose radiation therapy to the chest when you were young.
MAMMOGRAM GUIDELINES FOR AVERAGE RISK WOMEN
WHEN TO START
Start at Age 40: Many major groups, including the American College of Obstetricians and Gynecologists (ACOG) and the U.S. Preventive Services Task Force (USPSTF), now recommend that all women at average risk start screening every year or every two years beginning at age 40.
This recommendation was lowered because breast cancer diagnoses have been increasing in women aged 40 to 49.
HOW OFTEN TO GET SCREENED
Organization | Starting Age | Frequency |
ACR / Johns Hopkins Medicine | Age 40 | Every year (annually). |
American College of Obstetricians and Gynecologists (ACOG) | Age 40 | Every year or every 2 years. Decide with your doctor. |
American Cancer Society (ACS) | Age 45 (choice to start at 40) | Ages 45–54: Every year. Age 55+: Switch to every 2 years or continue yearly. |
U.S. Preventive Services Task Force (USPSTF) / CDC | Age 40 | Every 2 years (biennially). |
WHEN TO STOP SCREENING
Screening should generally continue if you are in good overall health. Many doctors recommend continuing screening past age 74, with no upper age limit, unless you have severe illnesses that limit your expected life span (such as less than five years of life left).
EXTRA SCREENING FOR DENSE BREASTS OR HIGH RISK
About half of women have dense breasts. Dense breasts have more fibrous tissue than fatty tissue. Dense tissue is an independent risk factor for breast cancer. It also makes it harder for a standard mammogram to find cancer, because the dense tissue can hide the cancer.
Starting in September 2024, mammography facilities must notify you if you have dense breasts. They must tell you that dense breast tissue increases your cancer risk. They also must tell you may need other imaging tests to find cancer.
SOURCES
US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2024;331(22):1918–1930. doi:10.1001/jama.2024.5534
Age to Initiate Routine Breast Cancer Screening: ACOG Clinical Practice Update. Obstetrics & Gynecology 145(1):p e40-e44, January 2025. | DOI: 10.1097/AOG.0000000000005757