Breast Cancer Screening Guidelines and Recommendations
For most people at average risk, national guidelines recommend beginning routine mammograms at age 40. If you have a higher risk, such as family history or genetic factors, you may need to start earlier.
Screening matters because it can detect breast cancer early, when treatment is most effective. Talk with your doctor about your risk level and the best time to begin screening.
Current Screening Recommendations for Average Risk
The U.S. Preventive Services Task Force, or USPSTF and the American Cancer Society are organizations that set widely recognized, evidence-based guidelines. USPSTF provides national standards that influence insurance coverage and clinical practice, while the American Cancer Society offers expert recommendations focused on cancer prevention and early detection.
US Preventive Services Task Force Guidelines:
- Start at 40
- Every 2 years (biennial screening) for most people at average risk
American Cancer Society Guidelines:
- Ages 40–44: Choice to begin annual screening
- Ages 45–54: Annual mammograms
- Age 55+: Continue yearly or switch to every two years, based on preferences and risk
Bottom line: Screening frequency can vary. Talk with your clinician about the schedule that fits your health history and preferences.
Recommendations for High-Risk
People at higher-than-average risk may need to start before age 40 and may benefit from additional imaging (for example, breast MRI). High-risk factors include:
- Specific genetic mutations (such as BRCA1/BRCA2)
- Family history of breast or ovarian cancer
- Prior breast cancer diagnosis
- Other clinical risk factors identified by your provider
Racial and Ethnic Differences in Risk
Breast cancer outcomes aren’t the same for everyone. Some groups face higher risks and may need earlier or more frequent screenings.
- Black Women: Research shows higher mortality rates, especially at younger ages. Some experts recommend starting screening before age 40 for black women.
- Ashkenazi Jewish Heritage: People of Ashkenazi Jewish descent have a higher chance of carrying BRCA1/BRCA2 mutations, which can increase breast cancer risk.
- Risk Assessment by Age 25: The American College of Radiology advises high-risk women, including Black women and those of Ashkenazi Jewish descent, to have a breast cancer risk assessment by age 25.
Why Do Recommendations Change?
With new medical research and advanced screening technologies, the recommendations for breast cancer screening can change over time. Updated mammogram screening guidelines reflect this ongoing scientific process.
Some scientific organizations support annual screenings, while others suggest biannual screenings.
The U.S. Preventive Services Task Force, or USPSTF, recently updated its guidance. For those at average risk, age 40 is now the recommended age to begin screening (previously, many began in their 50s). Screening plans should always reflect your personal and family history.
The American Cancer Society recommends the following:
- Ages 40 to 44: Women may choose to begin annual mammograms.
- Ages 45 to 54:Annual mammograms are recommended.
- Ages 55 and older: Women may screen annually or every two years based on personal preference and risk.
While different organizations may share different mammogram screening guidelines, the right time to begin screening should align with your health history, risk factors, and conversations with your care provider.
Why Guidelines Matter
Breast cancer affects about 240,000 women in the U.S. each year and causes roughly 42,000 deaths. National recommendations are built from decades of data and are designed to balance the benefits of early detection with the potential, but minimal, harms of unnecessary testing. These recommendations provide a general framework for the health care industry and patients to determine when to start screening. National recommendations from evidence-based organizations inform insurance coverage and help guide health care teams in preventive medicine decisions.
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Mammogram FAQs
Most people at average risk should start at age 40. Higher-risk patients may start earlier—talk with your clinician.
It is recommended that women should start getting annual mammograms every year starting at age 40. People who are high risk may need to start earlier or alternate with other types of testing, such as MRIs. Talk to your doctor to determine when you should start screening.
Most plans, including Medicare, cover screening mammograms every year if you are 40 years old or have high risk. Check your benefits for details.
Yes, annual mammograms are one of the best ways to detect breast cancer early, when treatment is most effective. Breast cancer can develop within a year, so regular screenings help catch changes before they become serious.
Do: Bring previous mammogram records if you have them, especially if this is a new provider. Wear a two-piece outfit for convenience.
Don’t: Use deodorant, lotion, powder, or perfume under your arms or on your breasts. These can interfere with the images.
Tip: Schedule your mammogram for a time when your breasts aren’t tender (avoid the week before your period).
Learn what to expect at your first mammogram.
Most women feel only brief pressure or mild discomfort during the test. The compression is important for clear images. If you’re worried, schedule your exam when your breasts are least tender and consider taking an over-the-counter pain reliever beforehand. The entire process usually takes about 10–15 minutes.