When should you get a mammogram?
Breast cancer screening saves lives, but when to start screening hasn't always been clear. While the age to start has been debated in recent years, most experts now agree that women should start having mammograms at age 40.
Posted — Updated“Starting mammograms at age 40 saves the most lives,” says UNC Health radiologist Genevieve Woodard, MD, PhD, chief of the UNC Breast Imaging Division.
“Screening for breast cancer reduces the death rate from breast cancer,” Dr. Woodard says. “Seventy percent of women who get breast cancer have no risk factors, including family history. Therefore, all women should start screening mammography at age 40, but some women may need to start earlier and may need additional screening exams.”
When to Start Getting Mammograms
Another group at risk is transgender women assigned male sex at birth and exposed to feminizing hormones, and transgender men assigned female sex at birth who have breast tissue present.
If you are pregnant or lactating, you can still get a mammogram, but unless you are at high risk or have symptoms that need to be diagnosed, you might want to wait until after delivery, Dr. Woodard says. There are minor risks of radiation from X-rays, even if most of your body is covered with a lead apron. When you are pregnant and lactating, your breasts are denser, which will make the mammogram harder to read.
No matter what your situation, talk to your doctor about your risk factors.
Women should continue getting mammograms as long as they are in good health and expect to live another 10 years or more, she says.
Types of breast cancer screening tests
Mammograms are X-rays of your breasts. As you stand before the mammogram machine, a technologist will place your breast flat on a plate or platform. Another plate will press down on your breast from above and the side, flattening your breast tissue to allow X-rays to produce a clearer image of breast tissue. This process may be uncomfortable but is not painful and lasts only a few minutes.
Tomosynthesis, or 3D mammograms, are becoming more widely used, Dr. Woodard says. They provide a more detailed look at the breasts than the traditional 2D images, and more insurance companies are covering the cost.
For people at high risk of breast cancer, doctors may also advise a breast MRI, which uses magnets and intravenous contrast to get information that a mammogram may not pick up. Mammograms reveal information MRIs may not, so an MRI doesn’t replace a mammogram but is supplemental.
The role of breast self-exams
“Know what’s normal for you,” Dr. Woodard says. “For example, if you perform a self-exam consistently, you’ll know if you have a little lump that comes and goes with your menstrual cycle, or if your nipple looks different, or one breast is unusually larger or smaller than the other.”
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