Mammogram Advice for Your 30s, 40s and Beyond

Breast care got really confusing a while back when recommendations were released for mammography screenings.

The U.S. Preventive Services Task Force (USPSTF) — a group of health experts — recommended that women start mammograms at age 50, instead of 40. Different groups, like the American Cancer Society, all weighed in on the issue. Everyone seemed to have a conflicting opinion.

So when should you get a mammogram? Are you too young? Too old?

To get some answers, we turned to Jennifer Harvey, MD, director of Breast Imaging at UVA.

In Your 30s

• Breast exams at your annual checkups are enough if you aren’t at high risk and you have no signs of breast irregularity.
• Women who have a family history of breast cancer and fall into the high-risk category should talk to their doctor about getting screening mammograms as early as age 25, Harvey says.

Harvey says digital mammography is more sensitive and preferred over traditional film screenings, especially for high-risk young women: “Only 30 percent of mammography machines used in the country are digital,” she says.

In Your 40s

• By 40, all women should begin annual mammograms in addition to clinical breast exams. Note that this is contrary to the task force recommendation, which says you can wait until age 50.
• The risks of mammography cited by the task force — like anxiety caused by a false positive result — are outweighed by the benefits. “Most women would prefer to be recalled and find the cancer early rather than not,” Harvey says.

In Your 50s and Beyond

• According to the National Cancer Institute, your risk of developing breast cancer increases as you age, so this is no time to sit out on your annual mammogram.
• If women move to a biannual screening at this point in their lives, as the task force recommends, up to 30 percent of cancers could be missed, says Harvey.
• Also disturbing, says Harvey, is the suggestion that women over age 74 stop getting mammograms altogether. “Breast cancer is very treatable at any age if found early.”

What About Self Exams?

For years, breast self exams have been a “must-do.” But the task force has downplayed the need for self exams.

“If you are high risk or feel comfortable doing your own breast exam, then you should absolutely continue to do them,” says Harvey. “In large clinical trials, self exam has not been shown to decrease mortality. Many lumps have been found by women during self exams, but we’re not certain they wouldn’t have been found any earlier by other means.”

Bottom Line: Talk to Your Doctor

No matter what your age, talk with your healthcare provider about:

• Your family medical history
• Any other potential risk factors you may have
• The screening methods that’s best for you

What do you think? Have you had a mammogram?