When Is It Time for Your First Mammogram?

Most people know at least one woman who has suffered through breast cancer. In the United States, breast cancer is the second-most common cancer in women after skin cancer, according to the National Cancer Institute. In fact, the institute estimates that 266,120 new cases of breast cancer will be found in 2018.

There are a lot of opinions about when and how often to get a mammogram, but when it comes to increasing your chance of survival with breast cancer, the earlier you screen for it, the better, says breast imaging diagnostic radiologist Holly Marshall, MD.

“We recommend annual mammograms beginning at age 40 and continuing every year, for as long as the woman is healthy,” Dr. Marshall says.

“There are many recommendations on when to start having a mammogram. Some say age 45, some say age 50. However, all these organizations agree and recognize the fact that beginning at age 40 saves the most lives. When the disease is caught early – and confined only to the breast – that affects survivability.”

Starting Earlier

Getting mammograms at age 40 isn't a hard, fast rule, however. Some women may need to start earlier.

“If you have a first-degree female relative who was diagnosed at an early age, then we recommend starting 10 years before the age when it first appeared in your relative,” she says. “For example, if your mother was diagnosed at age 45, then we recommend beginning annual mammograms at age 35.”

Risk Assessment

For women who may be genetically susceptible to breast cancer or have other types of cancers in their family, Dr. Marshall recommends getting a risk assessment done through the Center for Breast Cancer Prevention at University Hospitals.

Many employers help cover the insurance costs and/or co-pays of preventative services like mammograms, which makes their female employees more willing to seek care, according to the U.S. Preventive Services Task Force. That's because cancer has a significant impact on a company's bottom line by affecting productivity and contributing to lost work days.

Yet, some younger women avoid mammograms because they believe they have dense breasts and mammograms aren't necessary. It's a myth that isn't true, says Dr. Marshall.

“While it's true that younger women often have denser breasts, older women do, too,” she says. “In fact, about 50 percent of the population has dense breasts. This does lower the sensitivity for a mammogram, which is why we recommend having tomosynthesis – or a 3-D mammogram. It allows us to see through the tissue, increases cancer detection and decreases false positives.”

Sometimes, younger women aren't thinking about breast cancer yet, but Dr. Marshall says it's an important part of self-care. Even women in their 20s and 30s should learn how to do breast self-exams.

“I think it is important that all women remember that they need to take care of themselves first – before taking care of everyone and everything else,” she says.

To schedule your mammography or for other women’s health questions, contact University Hospital Women’s Health Institute or call 216-844-BRST (216-844-2778).

Holly Marshall, MD, is a breast imaging diagnostic radiologist at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Marshall or any University Hospitals doctor online.

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