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When to get a mammogram

October 29, 2018,

Each year the month of October is blanketed by pink to signify breast cancer awareness.  And while it certainly raises awareness, many women are still confused about when they need to get their first mammogram, how often, and how family history can play a factor.  Though women have been urged to get regular mammograms for the last 50 years, experts don’t necessarily agree about when women should begin the screenings:

  • The American Cancer Society recommends starting at 45.
  • The American College of Obstetricians and Gynecologists (ACOG) updated its recommendations to advise women to begin screening no later than 50, which they updated in 2017 from 40 years of age.
  • The U.S. Preventive Services Task Force, an independent panel of medical experts that evaluates preventive medical services, advises that women should begin screening at 50.

It’s extremely important to note that the recommendations from the three major groups are directed at women of average risk for breast cancer.  Women considered high risk those who have had breast cancer before, have a first-degree relative who had breast cancer, have had genetic testing that reveal a BRCA1 or BRCA2 genetic mutation, or those who have a history of multiple chest X-rays or radiation treatments to the chest.

If you’re not considered high risk, there are other factors that may help you determine when to get your first mammogram and how often to screen. These include:

  • Obesity, smoking, or excessive alcohol consumption.
  • History of noncancerous breast conditions.
  • Menstrual periods that started before age 12 or continued after 55.
  • Not having a child before 30.
  • A history of hormone replacement therapy.

Breast cancer becomes much more common after age 50, so starting screenings sooner increases the chance of false alarms and, possibly, unnecessary treatment. The U.S. Preventive Services Task Force estimates that at least one in eight tumors detected by mammography would never have spread, and that for every woman whose life is saved by mammography, two or three will be unnecessarily treated.  On the other hand, cancers that develop before menopause tend to be more aggressive, making it more important to catch them early.

To determine when you should begin mammograms, weigh your personal risk factors and speak candidly with your physician.


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