If you’re 40 years old, it’s time to start planning for regular cancer screenings. Anyone at average risk for colorectal cancer needs their first colonoscopy at age 45. And if you’re a woman, consider the importance of screening for breast cancer. But when should you start getting mammograms, exactly — at age 40 or 45? Or does it matter?

“When to start screening usually depends on a woman’s personal risk factors and family history of breast cancer,” says Dr. Ryland Gore, breast surgical oncologist at Methodist Cancer Institute. “However, I absolutely believe that screening mammograms should start at age 40 for a woman of average risk. Do not put them off until you’re in your 50s. Women who are at increased risk or have a genetic mutation should have a conversation with their physician to determine the best time to start their breast cancer screenings.”

Why You Need a Mammogram

Around 1 in 8 women will be diagnosed with breast cancer during their lifetime, according to the American Cancer Society. Screening mammograms, a special type of X-ray, can detect breast cancer up to three years before you can feel a lump in your breast. Breast cancer is often more easily treatable when it’s found in the early stages — before it has spread to a lymph node or elsewhere in your body.

“Mammograms are the best imaging tool we currently have for detecting breast cancer early,” Dr. Gore says. “Early treatment may lower your chances of dying from breast cancer.”

Risk Factors for Breast Cancer

Every woman is at some risk of breast cancer. However, certain women have a higher risk of developing the disease than others. Many risk factors are things you can’t change, such as:

Aging - Most women develop breast cancer after 50.

Breast density - If you have a lot of fibrous and glandular tissue in your breasts, you are considered to have dense breasts.

Family history - If you have a first-degree relative with breast or ovarian cancer, you also have a higher risk of developing either cancer.

Genetic mutations - Those include the BRCA1 and BRCA2 genes (which are most common in people of Ashkenazi Jewish descent and Black women). In addition to BRCA1 and BRCA2, there are multiple other genetic mutations that increase a person’s risk of developing breast cancer.

Race - Black women are at higher risk of developing breast cancer, including triple-negative breast cancer, the most aggressive form of the disease.

Reproductive history - Women who start their periods before age 12 or experience menopause after 55 have a higher risk.

Some risk factors are things you can change, including:

• Being overweight, especially after menopause
• Drinking alcohol
• Not being physically active

“Certain risk factors, such as genetic mutations, increase your risk of breast cancer more than others,” Dr. Gore says. “But having a higher risk for the disease does not guarantee you will develop it. However, it will likely affect when and how often you should get mammograms.”

Mammogram Screening Recommendations

Different organizations have different recommendations for when to start annual mammograms. The American Cancer Society guidelines for women at average risk state:

• Women 40-44 should have the option to start screening tests.
• Women 45-54 should get annual mammograms.
• Women ages 55 and older can continue annual mammograms or switch to screening every other year for as long as they are in good health and have a life expectancy of at least 10 years.

In May 2023, the U.S. Preventive Services Task Force — whose guidelines often impact insurance coverage — issued new draft recommendations that all women should start screening mammograms at age 40 but only get them every other year. Meanwhile, The American College of Obstetricians and Gynecologists and the American Society of Breast Surgeons recommend starting to screen at age 40 and getting a yearly mammogram.

However, every organization agrees on one thing: If you know you are at higher risk for breast cancer due to family, genetic or racial factors, you should talk to your doctor about starting screenings before 40. Some women may want to get a baseline mammogram in their 30s, while others at very high risk can start additional screenings such as breast MRIs.

“Your primary care provider or gynecologist can help you assess your risk and decide when to start screening,” Dr. Gore says. “So, really, when should you start getting mammograms? It is a personal choice, but as a surgeon who treats a lot of breast cancer patients, I agree with the National Comprehensive Cancer Network that screening mammograms should start at the age of 40, with a discussion with your physician regarding frequency or if screenings should start earlier.”

What to Expect During a Mammogram

A mammogram just takes a few minutes of your day. You will change into a hospital gown, and a technologist will use a special X-ray machine to take images of each breast, one at a time. During this process, your breasts will be pressed flat between two plates of the machine, and it may feel uncomfortable for a few seconds. You will receive your results within several days.

Methodist Le Bonheur Healthcare makes it easy to schedule your mammogram at one of five locations across the Mid-South. The Methodist Mobile Mammography service also offers convenient scheduling at events throughout the year.

Ready to Schedule Your Mammogram?

If you’re in your late 30s or 40s, talk to your doctor about when you should start screening mammograms at Methodist Le Bonheur Healthcare and make an appointment by calling 901-516-9000.