Breast cancer is the most common cancer in women. In 2022 there were about 287,000 cases of invasive cancer and 49,000 cases of non-invasive breast cancer in the US. The major risk factors for breast cancer are being a woman, white and older. Seventy-five percent of breast cancer occurs during menopause.
Mammograms can detect breast cancer at an earlier stage and reduce death rates.
During your annual medical exam, a risk assessment should be performed to determine your risk for developing breast cancer. We can determine your risk by taking your personal and family history. You are at high risk for breast cancer, for example, if you:
- Had abnormal breast biopsies
- Had radiation to your chest (age 10 – 30 years old)
- Carry BRCA gene mutations
- Had an early first period and/or late menopause
- Have very dense breasts
- Have a strong family history of breast cancer
- If we calculate your lifetime risk of breast cancer to be >20% (using Tyrer-cuzick tool)
Most women are at average risk for breast cancer (because of their personal and family history). For those women, we recommend mammograms at age 40 and then annually until age 74, continuing annually unless life expectancy is less than 10 years.
If you have dense breasts (50% of women), which can make it more difficult to detect breast cancer, we may also order a sonogram (ultrasound) with your mammogram. If your breasts are extremely dense, we might order a breast MRI.
If you are at high risk for breast cancer because of your personal or family history or other factors, your doctor may recommend that you begin mammograms and/or breast sonogram before age 40 and also offer a breast MRI.
Remember, mammograms save lives. The harms of mammograms are more call backs for more studies, benign biopsies (1%) and over diagnosis of breast cancer (<1%). However, mammograms allow for early detection of breast cancer, often before a tumor can be felt and when it is at its most curable stage. For this reason, the benefits of mammograms far outweigh the risks.