At what age should mammography start?
The general recommendation is forty; for women with a family history of breast cancer the programme starts earlier. Which interval applies in which situation.
The general rule: age forty
In women without symptoms, the point of screening is to catch the disease before the patient notices anything. Screening is therefore done not because you feel something, but because you feel nothing.
For women at average risk, annual mammography from the age of forty is the widely accepted approach. Some countries run their programme from fifty and every two years; that difference comes from the priorities of health systems, not from a scientific contradiction.
There is no single number for the upper limit either. Screening continues in women whose general health is good and whose life expectancy is over ten years.
When it should start earlier
In the situations below, screening starts earlier and MRI is sometimes added to mammography. We decide the right programme together after listening to your history.
- A first-degree relative (mother, sister, daughter) with breast cancer — usually starting ten years before that person’s age at diagnosis
- A family history of ovarian cancer or male breast cancer
- A known gene change such as BRCA1 or BRCA2
- Radiotherapy to the chest before the age of thirty
- A previous diagnosis of breast cancer, or of a pathology that raises risk
Which method is used when
The backbone of screening. Because it can show millimetre-sized calcifications that cannot be felt, nothing else replaces it for early diagnosis. Over the age of forty it comes first.
In young, dense breast tissue it covers the areas mammography cannot see well. It is also the quickest way to tell whether a lump is fluid or solid. On its own it is not a screening method.
Reserved for the high-risk group and selected situations. Its sensitivity is high, but because it also shows harmless findings it can lead to unnecessary biopsies. That is why it is not recommended for everyone.
Dense breast tissue is a phrase that appears often in mammography reports, and it is not a disease. It only means that imaging is harder; in that case adding an ultrasound comes into question.
Two frequently asked questions
The dose from one mammogram is very low, comparable to a few months of natural background radiation. The benefit of early diagnosis far outweighs a risk at that level.
The breast is compressed for a few seconds, which can be uncomfortable. Having the scan just after your period, when the breasts are less tender, makes it easier.
If your screening result mentions a suspicion, it does not mean you have cancer. In most women who are called back, further imaging clarifies the picture and the result turns out to be benign.
The content on this site is for general information and does not replace an examination by a physician. If you have symptoms, please book an appointment.
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