Breast Cancer Screening: Understanding the Guidelines

October 4, 2016 Brigham and Women's Hospital

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.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). In recognition of Breast Cancer Awareness Month, we will be publishing a three-part Breast Imaging Series throughout October. Today’s post, the first in our series, 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. Catherine Giess, Chief of the Division of Breast Imaging at Brigham and Women’s Hospital (BWH).  “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.

 

How often should I get a mammogram?

  • Women at average risk for developing breast cancer should have yearly mammograms until age 55. After age 55, mammograms may be obtained every other year.
  • Women who wish to continue yearly mammograms after age 55 and women at higher risk for developing breast cancer should continue annual screening.

 

Should I get a 3D mammogram or a 2D mammogram?

  • Digital 3D mammography (also known as 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. 3D mammography is currently standard of care for women receiving mammograms at BWH.
  • Depending on personal risk factors, supplementary imaging tools such as breast ultrasound or breast magnetic resonance imaging (MRI) may be appropriate.

 

The Division of Breast Imaging at Brigham and Women’s Hospital offers mammography and other breast imaging at multiple locations, including the Lee Bell Center at Brigham and Women’s Hospital in Boston, Brigham and Women’s Faulkner Hospital in Jamaica Plain, Brigham and Women’s/Mass General Health Care Center in Foxborough, and the Brigham and Women’s Health Care Center in Chestnut Hill.

-Jessica F.

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