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When Do I Need a Mammogram?

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Having a mammogram significantly reduces the chances that you’ll die from breast cancer, but when to get a mammogram has been a gray area lately, with conflicting recommendations on the right age to start and how often.

Mammograms are typically among the first of the age-related screenings recommended for women. If you have enjoyed good health up to now it may feel like overkill to start looking for cancer, but there’s a good reason.

“A mammogram can find breast cancer before you have symptoms or notice a lump, and early treatment gives you more options,” said Danielle Bertoni, MD, MPH, from Samaritan Medical Group Breast Center – Corvallis. “Breast cancer is, unfortunately, the most common type of cancer in women so it makes sense for women to be proactive about finding and treating it.”

The National Breast Cancer Foundation reports that one in eight women will develop breast cancer in her lifetime.

When to Have Your First Mammogram

There are several respected medical organizations that produce guidelines for when to have a screening mammogram. The American Cancer Society recommends the following for women at average risk of developing breast cancer:

  • Women between 40 and 44 have the option to start screening with a mammogram every year.
  • Women 45 to 54 should get a mammogram every year.
  • Women 55 and older can switch to a mammogram every other year, or continue yearly mammograms. Screenings should continue as long as you are in good health and expected to live at least 10 more years.

Dr. Bertoni noted that the American College of Radiology, the American Society of Breast Surgeons and the Society of Surgical Oncology, recommend that women start an annual mammogram at age 40, while the American College of Physicians recommendation is to start at age 50.

“There is some disagreement between medical experts about the right age to start an annual mammogram that boils down to the risks and benefits of false positives and overtreatment,” said Dr. Bertoni.

There may be more false positives when starting earlier, where women need to come back for additional testing and it ends up being nothing. Or cancers may be treated that would never have affected a woman’s health. However, the benefit of starting mammograms sooner is that cancer is most treatable with less invasive or less intense treatment when it’s caught early, Dr. Bertoni said.

“When to have your first mammogram is a decision you should discuss with your doctor so you can talk about your personal health and concerns,” said Dr. Bertoni.

If you are at high risk for developing breast cancer, the experts agree you will need to start some form of breast screening between the ages of 25 and 30. Women at high risk for breast cancer include those with family members who have had breast cancer, and women with an inherited gene mutation.

Changing Technology Improves Care

New advances like 3-D mammography, which is the standard of care at all Samaritan Diagnostic Imaging locations, has increased the detection of breast cancer and decreased false positives. During a 3-D mammogram, the machine moves around the breast in an arc to capture multiple images in 1mm increments.   

“Standard 2-D mammography uses two images on each breast to look for tumors, while 3-D mammography uses 100 to 200 images and allows us to see inside the tissue from many angles,” said Dr. Bertoni. “The procedure is delivered in the same way with essentially the same amount of radiation, but the improvement in what we can see is incredible.”

Know What’s Normal for You

A clinical breast exam or home self-exams are no longer recommended for breast cancer screening, but Dr. Bertoni reported that it’s still important to be familiar with what is normal for your breasts.

“In between mammograms, or if you haven’t had a mammogram yet, it’s good to periodically check your breast tissue for anything that’s unusual for you,” Dr. Bertoni said. “It’s common for some women to have lumpier tissue than others, but you want to check for anything that feels new or different.”

If you do find something unusual, call your doctor.

“The best way to approach your breast health is to talk with your primary care provider about your personal values and health concerns,” said Dr. Bertoni. “Having someone on your medical team whom you know and trust to help you make an informed decision is a great asset.”

Learn more about breast health, mammography services and cancer care at Samaritan, visit samhealth.org/Mammogram.