Breast cancer screening: when should I start?

When to start and how often

Sources: USPSTF (USPSTF 2024), American Cancer Society (ACS).

The USPSTF recommendation applies to cisgender women and all other people assigned female at birth, including transgender men and nonbinary people, aged 40 or older at average risk (USPSTF 2024).

Why the start age moved to 40

In 2016 the USPSTF recommended mammograms every other year from 50 to 74 and left the choice in the 40s up to each woman. In 2024 it changed this to every other year for all women from 40 to 74 (USPSTF 2024). It also noted that Black women are about 40% more likely to die of breast cancer than White women (USPSTF 2024).

Who is not at average risk

The USPSTF recommendation does not apply to people with a BRCA1 or BRCA2 gene change, high-dose radiation to the chest at a young age, a previous breast cancer, or a high-risk breast lesion found on biopsy (USPSTF 2024). For these people, the American Cancer Society says screening usually means a breast MRI and a mammogram every year, typically starting at 30 (ACS).

Family history is treated differently by the two groups. The USPSTF recommendation still covers people with a first-degree relative who had breast cancer (USPSTF 2024). The American Cancer Society counts a strong family history as a reason someone is not at average risk, and uses risk assessment tools to find people with a lifetime risk of about 20% to 25% or more (ACS). If a close relative had breast cancer, ask your doctor about a risk assessment.

Dense breasts

Nearly half of all women have dense breasts, which raises breast cancer risk and can make mammograms less accurate (USPSTF 2024). The USPSTF found too little evidence to recommend for or against extra tests such as ultrasound or MRI for dense breasts, and says all women, including those with dense breasts, should be screened starting at 40 (USPSTF 2024). Your mammogram report can tell you whether your breasts are dense.

Common questions

What age should a woman start getting mammograms?

At 40 for women at average risk, every other year, under the 2024 USPSTF recommendation (USPSTF 2024). The American Cancer Society gives the option of yearly mammograms from 40 and recommends them yearly from 45 (ACS).

When can I stop having mammograms?

The USPSTF found too little evidence to say either way for women 75 and older (USPSTF 2024). The American Cancer Society says to continue as long as you are in good health and expected to live at least 10 more years (ACS).

I am 35 and found a lump. Should I wait until 40?

No. Screening ages are for people without symptoms. A lump or any other change in a breast should be checked by a doctor at any age.

My mother had breast cancer. When should I start?

The USPSTF schedule from 40 still applies to you (USPSTF 2024), but your doctor may suggest a risk assessment, and some people with a strong family history start earlier or add MRI (ACS).

Also see the BRCA family history check, the cervical cancer screening check, the colon cancer screening check, the lung cancer screening check and the osteoporosis screening check.