August 15, 2023

Screening for breast cancer: Mammogram guidelines

Mammograms can help detect breast cancer early, when it’s easier to treat. Learn when you should get a mammogram and how to prepare for your screening.

Recommended breast cancer screening schedules vary based on your age and health history. Talk to your doctor about what makes sense for you.

Breast cancer is the second most common cancer among women and the second-leading cause of cancer death in the United States.1. Fortunately, regular mammograms can greatly increase the chance of detecting breast cancer early, when it's easier to treat and survival rates are highest.

When the COVID-19 pandemic began, breast cancer screening rates dropped due to stay-at-home orders and concerns about catching the virus. Mammography rates are rising, but they're still nearly 15% below2 pre-pandemic levels.

Alison Sandberg, MD, a breast radiologist at Kaiser Permanente in Colorado, explains why it's important to stay up to date on your mammogram.

What are mammograms?

A mammogram is an X-ray picture of the breast that is used to look for early signs of breast cancer. Regular mammograms are the best tests doctors use to find breast cancer early, sometimes up to 3 years before it can be felt in a physical exam.

When should I start getting mammograms?

There's no one-size-fits-all answer. Start by having a conversation with your doctor to determine your individual risk. Your doctor will ask you about your personal and reproductive history and your family history of breast cancer.

"This is especially important for women of African American or Ashkenazi Jewish descent, who may be at higher risk," Dr. Sandberg said.

At Kaiser Permanente, women with average breast cancer risk have the option of beginning annual mammograms anytime in their 40s. For women with above-average risk, recommended screening schedules vary. Talk to your doctor about your specific situation.

For women aged 50 to 75 with average breast cancer risk, Kaiser Permanente recommends mammograms every 1 to 2 years. Women aged 75 and up should talk with their physician about the benefits and risks of continued screening.

What does it mean to have dense breasts?

All breasts contain glandular, connective, and fatty tissue. Dense breasts have higher amounts of glandular and connective tissue and lower amounts of fatty tissue. Nearly half of all women 40 and older have dense breasts. Only a mammogram can show if a woman has dense breasts — it can't be felt in an exam.

Women with dense breasts have a higher chance of getting breast cancer. Dense breasts can also make it harder for doctors to evaluate mammogram results because fibrous and glandular tissue can look similar to a tumor. Getting regular mammograms allows your doctor to see small changes in your breasts over time.

Are mammograms safe?

When you get a mammogram, you are briefly exposed to a very small amount of radiation. But the benefits of mammography outweigh any possible harm from the radiation exposure. In fact, the dose of radiation used for a mammogram of both breasts is roughly equal to the background radiation you’re exposed to by living in the United States for 7 weeks.

Does mammography screening work?

Yes. Mammography has helped reduce breast cancer mortality in the U.S. by nearly 40% since 1990.

"What we're doing is saving lives," said Dr. Sandberg.


3 tips for your next mammogram


1. Plan ahead

Avoid scheduling your mammogram the week before your period, when your breasts are more tender.

2. Dress for comfort

Wear a shirt or blouse so you only need to undress from the waist up.

3. Avoid deodorant and lotion

Do not apply deodorant or lotion before a mammogram, as these may contain ingredients that could distort the image or make your breasts slippery.