October is Breast Cancer Awareness Month. You’ve probably seen plenty of reminders about mammograms, early detection, and the importance of breast health. But here’s a question that isn’t always so easy to answer:
When should you actually start getting mammograms?
You may have heard age 40. Or maybe someone told you 45 or 50. You might also wonder whether you need a mammogram every year or every other year. If the recommendations seem confusing, you’re not alone. Breast cancer screening guidelines have changed over time, and different medical organizations don’t always recommend the same schedule.
At South Tabor Family Physicians, we believe patients deserve clear information to help them make informed decisions about their health. Let’s look at what’s changed, why recommendations differ, and what you should know about your own breast cancer risk.
What Has Changed About Breast Cancer Screening?
One of the most important changes came in 2024, when the U.S. Preventive Services Task Force (USPSTF) updated its breast cancer screening recommendations. The Task Force now recommends that women at average risk begin screening mammograms at age 40 and continue every two years through age 74. Previously, its routine screening recommendation began at age 50, with screening during the 40s treated as an individual decision.
Why the change?
Research showed that starting regular mammograms at age 40 could help prevent more breast cancer deaths. The goal of screening is to find breast cancer early, sometimes before a person notices any symptoms. Finding cancer earlier can mean more treatment options and a better chance of successful treatment.
Why Do Different Organizations Recommend Different Ages?
This is where things can get confusing. Several respected medical organizations publish breast cancer screening guidelines. They review much of the same research but may place different weight on the benefits and possible downsides of screening. For example:
U.S. Preventive Services Task Force (USPSTF)
- Ages 40–74: Mammogram every two years.
- Ages 75 and older: Not enough evidence to recommend one screening schedule for everyone.
American Cancer Society (ACS)
- Ages 40–44: Option to begin yearly mammograms.
- Ages 45–54: Yearly mammograms recommended.
- Ages 55 and older: Mammograms every two years, or continue yearly if preferred, while in good health and expected to live at least 10 more years.
American College of Radiology (ACR)
- Recommends yearly mammograms beginning at age 40 for women at average risk.
So which recommendation is right? The answer depends partly on your health history, risk factors, and personal preferences. These guidelines are meant to help patients and providers make decisions together. They aren’t a substitute for looking at each person’s individual health needs.
Why Not Just Get a Mammogram Every Year?
It’s a reasonable question. Mammograms can save lives by finding breast cancer early. But screening also has limitations. Sometimes a mammogram shows something unusual that turns out not to be cancer. This is called a false-positive result.
A false-positive result may lead to additional imaging, appointments, or a biopsy. Screening can also find some cancers that would never have caused symptoms or become dangerous during a person’s lifetime. This is called overdiagnosis, and it can lead to treatment that may not have been necessary.
These possibilities are part of why screening recommendations differ. The goal is to find the right balance between detecting important cancers early and avoiding unnecessary testing or treatment. For many patients, the decision about yearly versus every-other-year screening is worth discussing with their primary care provider.
What If Breast Cancer Runs in Your Family?
Your family health history can affect when you should begin screening and which tests may be appropriate. Some people have a higher-than-average risk of developing breast cancer.
Risk factors can include:
- A mother, sister, daughter, or other close relative with breast cancer
- Several relatives with breast or ovarian cancer
- A known inherited genetic change, such as BRCA1 or BRCA2
- A personal history of breast cancer or certain high-risk breast conditions
- Radiation treatment to the chest at a young age
Family history on both your mother’s and father’s sides matters. People at higher risk may need screening earlier than age 40 or additional tests, such as breast MRI.
The American Cancer Society recommends that many women at high risk receive both a mammogram and breast MRI every year, often beginning around age 30. The exact age and testing plan depend on the reason for the increased risk.
And remember: most people who develop breast cancer do not have a known family history of the disease. Having no family history does not mean screening is unnecessary.
What Are Dense Breasts, and Why Do They Matter?
You may have heard the term dense breasts after a mammogram. Breast density describes how much glandular and connective tissue is present compared with fatty tissue.
Dense breast tissue is common. It can also make breast cancer harder to see on a mammogram because dense tissue and some cancers can look similar on the images. Having dense breasts is also associated with a higher risk of breast cancer.
Federal rules now require mammography facilities to include information about breast density in the results they send patients. Does having dense breasts mean you need additional screening? Not necessarily.
Some patients may benefit from additional imaging, but the best approach depends on their overall risk. Research is still ongoing about which additional screening methods offer the greatest benefit for women with dense breasts. If your mammogram report says you have dense breasts, ask your provider what that means for your screening plan.
Do Mammograms Hurt? What Should You Expect?
If you’ve never had a mammogram, you might be nervous about what the test involves. A mammogram is a low-dose X-ray of the breast. During the exam, a technologist positions each breast between two plates. The breast is compressed briefly so clear images can be taken.
You may feel pressure or discomfort, but the compression usually lasts only a few seconds for each image. The appointment itself is generally fairly quick.
A few things to remember:
- Tell the technologist if you have breast implants or any breast concerns.
- Avoid deodorant, powders, or lotions on your underarms or breasts on the day of your exam if the imaging facility instructs you to do so.
- Let the technologist know if you’re experiencing pain or discomfort.
Mammograms aren’t perfect, but they remain one of the most important tools available for detecting breast cancer early.
What If You Notice a Lump or Other Breast Changes?
Routine screening is designed for people who do not have symptoms. But if you notice a change in your breast, don’t wait for your next scheduled mammogram. Changes worth discussing with your provider include:
- A new lump in the breast or underarm
- Changes in breast size or shape
- Skin dimpling, thickening, or redness
- New nipple changes, including a nipple turning inward
- Nipple discharge, especially if bloody
- Persistent pain in one area of the breast
Many breast changes are not cancer. Still, new or unusual symptoms deserve attention. Your provider may recommend a clinical exam, diagnostic mammogram, ultrasound, or other testing depending on your symptoms.
What About Breast Cancer Screening After Age 74?
There isn’t one answer that fits everyone. The USPSTF states that there isn’t enough evidence to determine the benefits and harms of routine screening mammograms after age 74.
The American Cancer Society recommends continuing screening if a woman is in good health and is expected to live at least another 10 years.
For older adults, the decision may depend on overall health, medical conditions, life expectancy, and personal preferences. Age alone doesn’t tell the whole story. A conversation with your provider can help determine whether continuing mammograms makes sense for you.
Five Questions to Ask at Your Next Preventive Care Visit
Breast Cancer Awareness Month is a good reminder to review your screening plan. Consider asking your primary care provider:
- Based on my age and health history, when should I start or continue mammograms?
- Should I be screened every year or every other year?
- Does my family history or breast density change my risk?
- Would I benefit from genetic counseling or additional screening?
- What should I do if I notice a change between mammograms?
These are important questions at any age, and you don’t have to figure out the answers on your own.
Breast Cancer Awareness Is About More Than Wearing Pink
Breast Cancer Awareness Month is an opportunity to move beyond reminders and take practical steps toward better health. That might mean scheduling a mammogram, learning more about your family history, reviewing an earlier screening result, or simply asking your provider whether your screening plan is up to date.
The most important message isn’t that everyone needs the same screening schedule. It’s that everyone deserves a screening plan that reflects their individual needs.
At South Tabor Family Physicians, our providers work with patients to understand their health history, discuss preventive care recommendations, and make informed decisions together. Early detection matters. So does understanding what’s right for you.
Helpful Resources
U.S. Preventive Services Task Force — Breast Cancer Screening Recommendations
Learn about the updated recommendation to begin screening at age 40 and why the guidelines changed.
American Cancer Society — Breast Cancer Screening Guidelines
Review mammogram recommendations by age, along with guidance for women at higher risk.
American College of Radiology — Breast Cancer Screening for Higher-Risk Women
Learn why some women benefit from earlier risk assessment and additional screening.
South Tabor Family Physicians has been caring for individuals and families in the Portland community for more than 60 years, offering comprehensive care at every stage of life. We’re conveniently located right off I-205 and are accepting new patients.
Call 503-261-7200 to schedule your next visit or get to know our providers here.
