Breast Cancer Screening: Understanding the Guidelines

Posted by Brigham and Women's Hospital October 4, 2016

Digital 3D mammography (digital breast tomosynthesis), the latest technology used in mammography, takes multiple images of each breast from different angles. It has been shown to improve earlier detection of breast cancers and reduce the number of call backs for repeat imaging.

Contributor: Dr. Catherine Giess is Chief of the Division of Breast Imaging at Brigham and Women’s Hospital and Assistant Professor of Radiology at Harvard Medical School.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). This post is designed to outline breast cancer screening guidelines.

“Mammography is a very important screening tool for early breast cancer detection, but there are several different guidelines for when to start and how often to undergo mammography,” says Dr. Giess.  “This can be confusing for many women.”

The American College of Radiology recommends annual screening mammography beginning at age 40.  The ACS guidelines (outlined below) emphasize screening based on a woman’s individual risk of developing breast cancer and her personal preferences.


When should I start?

A woman’s first mammogram serves as a baseline to compare results of subsequent mammograms.

  • Women should begin discussing breast cancer screening with their health care providers at age 40. From 40-44 years of age, women have the option to begin annual screening if they choose to do so.  All women should begin yearly mammograms by age 45.
  • Women who are at higher risk for developing breast cancer, such as women with a family history of breast or ovarian cancer, should discuss their own personal risk factors with their health care providers, and may need to start screening earlier.

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The Latest about Mammography: Benefits, Risks, and Choices

Posted by Brigham and Women's Hospital May 8, 2014

Opinions continue to vary about when a woman should start getting a mammogram and how frequently thereafter.

A team of Brigham and Women’s Hospital (BWH) researchers recently examined 50 years of international breast cancer screening research data to assess the benefits and risks of mammography. Their determination: the benefits of mammography are modest, and the harms are significant, making it very important that women make informed decisions about screening.

“There are benefits to mammography in decreasing the likelihood that a woman will die of breast cancer,” says report co-author Dr. Nancy Keating, a physician in the BWH Division of General Internal Medicine and Primary Care and an associate professor of Health Care Policy at Harvard Medical School. “But those benefits are not enormous.”

Those benefits also vary according to age, as well as other risk factors, such as family history. The report authors estimate that for every 10,000 women aged 40-49 who get annual mammograms for the next 10 years, approximately 190 of those women will be diagnosed with breast cancer. Of those 190, 5 will avoid death because of getting a regular mammogram, 25 will die regardless of their regular screening, and the majority (160) will survive, also regardless of regular screening. As a woman gets older, however, the benefit of routine mammography steadily increases, accounting for:

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