When to Get a Mammogram

Topic: When to Get a Mammogram

Expert groups often disagree with each other on breast cancer screening. CR makes sense of the different recommendations.

Every October marks Breast Cancer Awareness Month, which always brings a flurry of reminders to women to stay up to date with their mammograms: X-rays that help detect lesions in the breast that may signal cancer. After a year when—according to research by the Centers for Disease Control and Prevention—many people appeared to delay their routine screenings because of the COVID-19 pandemic, these reminders may feel particularly urgent.

But determining who actually needs a mammogram is not so straightforward. Cancer experts don’t agree on when women should begin to have this breast cancer screening test, or how often to do so.

For instance, the U.S. Preventive Services Task Force (USPSTF), an independent panel of medical experts that evaluates preventive medical services, says women at average breast cancer risk should start screenings at age 50.

But the American Cancer Society (ACS) recommends starting at 45, and the American College of Radiology (ACR) advises beginning at age 40.

And the American College of Obstetricians and Gynecologists (ACOG) says women should start screening no later than age 50 but with the choice to begin sooner.

Why the different advice? In part, it’s because these expert groups may evaluate scientific studies on mammography differently, some placing more weight on the benefits of mammography and some emphasizing the screening’s potential downsides, according to the American College of Physicians (ACP).

They may also differ in the types of studies they rely on or on how to grapple with issues of cost when writing screening recommendations.

The result: “Both patients and clinicians are frustrated and sometimes confused,” says Joann Elmore, MD, MPH, professor of medicine at the David Geffen School of Medicine at UCLA, and director for the UCLA National Clinician Scholars Program.

In addition, like all screening tests, mammograms themselves have their pros and cons.

Here, what to know about mammography, what the various recommendations may mean for you, and how to work with your doctor to make the best decision for yourself.

Topic Discussed: When to Get a Mammogram

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