The Who, What, Where, When and Sometimes, Why.

Breast Cancer Screening for Women at Average Risk

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Mammography is the most effective screening tool used today to find breast cancer in most women. However, the benefits of mammography vary by age.

Learn about mammography for women ages: 

Figure 3.1 (below) shows the breast cancer screening recommendations for women at average risk from some major health organizations [2-4].  

Learn about screening recommendations for women at higher than average risk of breast cancer.  

Figure 3.1: Breast cancer screening recommendations for women at average risk
American Cancer SocietyNational Comprehensive Cancer Network U.S. Preventive Services Task Force 

Mammography

Informed decision-making with a health care provider ages 40-44

Every year ages 45-54

Every 2 years (or every year if a woman chooses to do so) starting at age 55, for as long as a woman is in good health

Every year starting at age 40, for as long as a woman is in good health 

Informed decision-making with a health care provider ages 40-49

Every 2 years ages 50-74

Clinical Breast Exam

Not recommended

Every 1-3 years ages 25-39

Every year starting at age 40

Not enough evidence to recommend for or against

*The American Cancer Society and the National Comprehensive Cancer Network guidelines state 3D mammography (breast tomosynthesis) may be used for screening mammography.

 

Women Should Have Access to and Coverage for Mammography

Susan G. Komen® believes all women should have access to regular screening mammograms when they and their health care providers decide it is best based on their personal risk of breast cancer. In addition, screening should be covered by insurance companies, government programs and other third-party payers. Read more.

Figure 3.1 shows breast cancer screening recommendations for women at average risk.

Benefits of mammography for women ages 40-49

Mammography in women ages 40-49 may lower the risk of dying from breast cancer, but the benefit is less than for older women [8,28].

The U.S. Preventive Services Task Force meta-analysis combined the results from 8 randomized controlled trials. It found no clear difference in the risk of dying from breast cancer for women ages 39-49 who got mammograms on a regular basis and their peers who did not get mammograms [28]. If there was a difference, it was likely very small. 

There are a few reasons why there’s less benefit from mammography for younger women than for older women [29]:

  • Women ages 40-49 have a lower risk of breast cancer than older women.
  • Younger women tend to have dense breast tissue, which can make abnormal findings hard to see on a mammogram.
  • Breast cancers in younger women tend to grow faster than breast cancers in older women. This means mammography every 1-2 years may be less likely to find breast cancers in younger women early, when the chances of survival are highest.

For younger women, there are also some drawbacks of screening mammography.

Risks of mammography for women ages 40-49

Over-diagnosis and over-treatment are risks of mammography. Over-diagnosis and over-treatment occur when a mammogram finds a cancer that never would have caused symptoms or problems if it had never been diagnosed and had been left untreated.

Another drawback of mammography in women ages 40-49 is a high rate of false positive results (when a screening test shows there’s cancer when in fact, cancer isn’t present) [28].

Younger women are more likely than older women to have a false positive result on a mammogram. This is due to a number of reasons including the low number of breast cancers that occur in younger women and higher breast density in younger women.

Getting a false positive result means these women will be told they have an abnormal finding and undergo follow-up tests, only to find they don’t have breast cancer. Follow-up tests may include a follow-up mammogram (diagnostic mammogram), breast ultrasound or even a biopsy.

Learn more about follow-up of an abnormal mammogram.

Why are there different screening recommendations for women ages 40-49?

Mammography in women ages 40-49 may lower the risk of dying from breast cancer, though the benefit is less than for older women [8,28]. Some major health organizations have concluded these modest potential benefits of mammography for women in their 40s outweigh the risks of false positive results, over-diagnosis and over-treatment [3-4].

The National Comprehensive Cancer Network recommends routine mammography for women starting at age 40 [3]. The American Cancer Society recommends routine mammography starting at age 45 [4].

Weighing the benefits and risks, the U.S. Preventive Services Task Force does not recommend routine mammography for all women 40-49 [2].

Instead, the Task Force, as well as the American College of Physicians, recommends women 40-49 talk with their health care providers about their risk of breast cancer and the pros and cons of mammography. Then, together, make informed decisions about when to start mammography screening and how often to get screened [2,29].

Similarly, the American Cancer Society recommends informed decision-making for women ages 40-44 [4].

Informed decisions are guided by a woman’s breast cancer risk profile. Women at higher than average risk of breast cancer are more likely to benefit from mammography [2,4,29].

Decisions should also be guided by a woman’s preferences based on the potential benefits and risks of mammography [2,4,29].

Talk with your provider about when to start mammography screening.

Learn more about weighing the benefits and risks of mammography, including information on over-diagnosis and over-treatment. 

 52805-2.gifFor a summary of research studies on mammography in women ages 40-49, visit the Breast Cancer Research Studies section.  
 52805-2.gif

For a summary of research studies on 3D mammography for breast cancer screening, visit the Breast Cancer Research Studies section.

 

Figure 3.1 shows breast cancer screening recommendations for women at average risk.

Benefits of mammography for women ages 50-69

For women ages 50-69, the benefits of mammography are clear. Mammography lowers a woman’s risk of dying from breast cancer. It’s recommended women ages 50-69 have mammograms on a regular basis.

Individual study findings on the benefits of mammography vary.

The U.S. Preventive Services Task Force meta-analysis combined the results from 6 randomized controlled trials and found [28]:

  • Women ages 50-59 who got mammograms on a regular basis had a 14 percent lower risk of dying from breast cancer than women who did not get mammograms.
  • Women ages 60-69 who got mammograms on a regular basis had a 33 percent lower risk of dying from breast cancer than women who did not get mammograms.

How often should women ages 50-69 get mammography screening?

The U.S. Preventive Services Task Force recommends mammography every 2 years for women 50-69 [2].

The Task Force reviewed the scientific evidence and concluded mammography every 2 years gives almost as much benefit as mammography every year while reducing risks [28]. These risks include false positive results, over-diagnosis and over-treatment

The American Cancer Society recommends mammography every year for women ages 50-54 and every 2 years for women ages 55 and older [4].

Other health organizations recommend women 50-69 have mammograms every year [3].

If you’re 50-69, talk with your health care provider about how often to get a mammogram.

Learn more about weighing the benefits and risks of mammography, including information on over-diagnosis and over-treatment. 

For a summary of research studies on mammography in women ages 50-69, visit the Breast Cancer Research Studies section.

 52805-2.gif

For a summary of research studies on 3D mammography for breast cancer screening, visit the Breast Cancer Research Studies section.

 

Figure 3.1 shows breast cancer screening recommendations for women at average risk.

There are few studies (and no randomized controlled trials) on the benefits of mammography in women ages 70 and older.

The U.S. Preventive Services Task Force recommends mammography every 2 years for women ages 70-74 [2]. However, it feels there’s not enough scientific evidence to recommend for or against routine mammography screening in women ages 75 and older [2].

Breast cancer risk increases with age, and mammography doesn’t appear to be less effective in women 70 and older. However, there are risks of mammography in older women, including over-diagnosis and over-treatment.

Many major health organizations, including the American Cancer Society, recommend women ages 70 and older continue to get mammograms on a regular basis as long as they are in good health [3-4,30].

Some women may stop routine breast cancer screening due to poor health. Women who have a serious health problem may not benefit enough from having breast cancer found early to justify screening.

However, women who are in good health and could benefit from treatment (if breast cancer were found) should continue to get mammograms.

If you aren’t sure whether you should continue getting mammograms, talk with your health care provider.

Although mammography saves lives, it has some drawbacks.

Learn about the benefits and risks of mammography

 

 

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