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When Should I Have My First Mammogram?

June 24, 2024

If you flipped on the news over the past month or so, you’ve probably heard that there are new guidelines about mammograms. What does that mean for you and when should you have your first mammogram?

You likely know that mammograms play a key part in detecting breast cancer. Having regular mammograms makes it more likely that cancer will be detected in an early stage when it’s most treatable.

That’s really important. The five-year survival rate for breast cancer detected in a localized stage, meaning it has not spread, is 99%. Those are excellent odds.

Don Wilson, MD | West Tennessee Medical Group GYN Specialists

“The best protection is early detection,” says Dr. Don Wilson, gynecologist with West Tennessee Medical Group GYN Specialists.

But while you know mammograms are important, you may be confused about when you should start having them and how often you need one. That’s only natural—if you attempt to look up the information online, you’ll find several different sets of recommendations.

That’s enough to confuse anyone! And those recommendations can and do change over time, making it even more confusing.

That’s why we’re pausing to break down the latest info in today’s blog. Keep reading to get the details.

Q: What Do the Latest Mammogram Guidelines Say?

A: Mammograms have been in the news lately because the U.S. Preventive Services Task Force (USPSTF) released a new draft recommendation statement on May 9.

Previously, the task force recommended that women begin having mammograms every other year beginning at age 50. The new guidance recommends that women begin having biannual mammograms at age 40 instead.

The change was made because many women are diagnosed with breast cancer in their 40s, and breast cancer diagnosed during that time can spread rapidly. Research has also shown that when mammograms don’t begin until age 50, breast cancer goes undetected in many minority women, including Black and Hispanic women, among others.

The previous recommendation to begin at age 50 was made in an attempt to lower the risk of having unnecessary testing when suspicious tissue is spotted on a mammogram. The added cost and stress of testing, however, is outweighed by the need to detect mammograms in their earliest stages.

Q: Weren’t Mammograms Already Recommended Starting at Age 40?

A: Yes, actually. What’s confusing about guidelines for using mammograms as a breast cancer screening is that there are several different sets of guidelines—and they don’t match.

Even though the U.S. Preventive Services Task Force previously recommended beginning mammograms at age 50, other organizations already called for earlier screening.

The American Cancer Society, for example, recommends that women be given the opportunity to begin annual mammograms starting at age 40, with all women having a first mammogram by age 45. The American Congress of Obstetricians and Gynecologists (ACOG) has a similar recommendation, calling for screening mammograms beginning at age 40. 

The differing guidelines—paired with the fact that many women experience breast cancer in their 40s—is a big reason that many OB/GYNs and other women’s health specialists have continued recommending having a first mammogram at age 40, not 50.

Q: How Often Should I Have a Mammogram?

A: Recommendations differ on this point, too. The American Cancer Society recommends having a mammogram annually from age 40 through at least age 54. After that, they recommend talking with your medical provider about whether you should continue with an annual mammogram or have one every other year.

The ACOG recommends that women at average risk of breast cancer have a mammogram at age 40 and every one to two years thereafter.

The new USPSTF guidelines recommend having a mammogram every two years beginning at age 40.

How can you make sense of all that? Talk with your medical provider. He or she will be familiar with your overall health and your risk factors, allowing for a personalized recommendation about mammogram frequency. 

Q: Does Breast Density Matter When It Comes to Mammograms?

A: Yes! Having dense breast tissue increases a woman’s risk of developing breast cancer. That’s due to a number of factors, including the fact that dense tissue appears white on mammograms, which is the same color as cancerous tissue. This can make it more difficult to spot tumors and other suspicious areas on mammograms.

You’ll note that the guidelines listed above are for women at average risk of breast cancer. When you have risk factors, like dense breasts, your medical provider may recommend extra precautions, such as having more frequent mammograms or having supplemental imaging scans in addition to screening mammograms.

How would you know if your breasts are dense? When you have your first mammogram (and subsequent ones), you’ll receive a notice indicating if you have dense breast tissue. Many women do—around 40% of all American women have what’s known as heterogeneously dense breast tissue.

If you get this note, talk with your OB/GYN about your next steps. You should also talk with your medical provider about any other risk factors that you have, including a family history of breast cancer.  

Wondering when you should have your first mammogram and how often you need one? An OB/GYN can answer your questions! Schedule an appointment today with one of the providers with West Tennessee Medical Group Women’s Health.