You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
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This information is for women who are choosing to have screening mammograms and who are at average risk for breast cancer. It is not for women who are at high risk. If you don't already know your breast cancer risk, you can ask your doctor. Or you can go to www.cancer.gov/bcrisktool/ to look it up.
A mammogram is an X-ray of the breast that is used to look for breast cancer.
There are two types of mammograms.
This decision aid is about screening mammograms.
Mammograms can find some breast cancers early, when the cancer may be more easily treated. Often a mammogram can find cancers that are too small for you or your doctor to feel.
Studies show that a small number of women who have mammograms may be less likely to die from breast cancer.
The risk for breast cancer goes up as you get older. In general, women younger than 50 are at a lower risk for breast cancer. Because of this, women ages 50 to 70 are more likely to benefit from having a mammogram than women who are in their 40s.
Each time you have a mammogram, there is a risk that the test:
Ages 40–49 | About 19 out of 1,000 women |
---|---|
Ages 50–59 | About 30 out of 1,000 women |
Ages 60–69 | About 44 out of 1,000 women |
*Based on the best available evidence (evidence quality: moderate to high)
| Women who have mammograms | Women who don't have mammograms | Mammograms making a life-saving difference |
---|---|---|---|
Ages 40–49 | About 3 out of 1,000 will die of breast cancer | Between 3 and 4 out of 1,000 will die of breast cancer | For less than 1 out of 1,000 women |
Ages 50–59 | About 6 out of 1,000 will die of breast cancer | About 7 out of 1,000 will die of breast cancer | For about 1 out of 1,000 women |
Ages 60–69 | About 9 out of 1,000 will die of breast cancer | About 13 out of 1,000 will die of breast cancer | For about 4 out of 1,000 women |
*Based on the best available evidence (evidence quality: moderate to high)
Mammograms can find some breast cancers early, when the cancer may be more easily treated. Often a mammogram can find cancers that are too small for you or your doctor to feel.
Take a group of women who have a mammogram every year for 10 years.footnote 1
Studies show that a small number of women who have mammograms may be less likely to die from breast cancer. Since the risk for breast cancer goes up as you get older, women ages 50 to 70 are more likely to benefit from having a mammogram than women who are in their 40s.
Take a group of women who have a mammogram every year for 10 years.footnote 1
The numbers in the tables and narratives include women who are expected to be diagnosed with invasive breast cancer or an early form of noninvasive breast cancer called ductal carcinoma in situ.
| Number of women who will have at least one false-positive that results in more testing (but turns out not to be cancer) | Number of women who will have a biopsy they don’t need |
---|---|---|
Ages 40–49 | About 613 out of 1,000 women | About 70 out of 1,000 women |
Ages 50–59 | About 613 out of 1,000 women | About 94 out of 1,000 women |
Ages 60–69 | About 497 out of 1,000 women | About 98 out of 1,000 women |
*Based on the best available evidence (evidence quality: moderate to high)
Mammograms may show an abnormal result when it turns out there wasn't any cancer (called a false-positive). This means you may need more tests—such as another mammogram, a breast ultrasound, or a biopsy—to make sure you don't have cancer. These tests can be harmful and cause a lot of worry.
Take a group of women who have a mammogram every year for 10 years.footnote 1
Breast cancer screening can also lead to unnecessary biopsies.
Take a group of women who have a mammogram every year for 10 years.footnote 1
Mammograms may find cancers that would never have caused a problem if they had not been found through screening (called over diagnosis). But a mammogram can't tell whether the cancer is harmless. So you may get cancer treatment that you don't need.
Out of 1,000 women who are diagnosed with breast cancer during screening mammograms, experts estimate that about 190 of them may get treatment they don't need.footnote 1
The numbers in the tables and narratives include women who are expected to be diagnosed with invasive breast cancer or an early form of noninvasive breast cancer called ductal carcinoma in situ.
Some evidence is better than other evidence. Evidence comes from studies that look at how well treatments and tests work and how safe they are. For many reasons, some studies are more reliable than others. The better the evidence is—the higher its quality—the more we can trust it. The information shown here is based on the best available evidence.footnote 1 The evidence is rated using four quality levels: high, moderate, borderline, and inconclusive.
Another thing to understand is that the evidence can’t predict what's going to happen in your case. When evidence tells us that 2 out of 100 people who have a certain test or treatment may have a certain result and that 98 out of 100 may not, there's no way to know if you will be one of the 2 or one of the 98.
Experts agree that mammograms are the best screening test for women at average risk. But they don’t all agree on the age at which a woman should start or whether it is better for her to be screened every year or every two years.
Here are some of the recommendations from experts:
When to stop having mammograms is another decision. You and your doctor can decide on the right age to stop screening based on your personal preferences and overall health.
Compare
What is usually involved? |
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What are the benefits? |
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What are the risks and side effects? |
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These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
No one in my family has ever had breast cancer. So I'm not at high risk for getting it. I talked with my doctor about this, and I read all of the information I could. My doctor says it's my decision, but she is here to answer any questions and talk it over. I'm worried about false positives. I have a friend who has had two biopsies, and many sleepless nights, and it turned out to be nothing. I'm having a tough time deciding. I think for me the best decision is no decision. I'll keep reading and thinking about it. I’m okay with this.
Keiko, 41
I’ve already talked to my doctor about getting a mammogram when I turn 40 next year. Taking action is really important to me when it comes to my health. My older sister started having mammograms when she turned 40. She got a call once because they found something on her mammogram, but after more testing it turned out to be nothing serious. I want to have that reassurance—the peace of mind is worth it to me.
Jaime, 39
I'm not really worried about getting breast cancer, so I've decided to wait until I'm 50 to start having mammograms. I just turned 40, and I've always been healthy and active. Plus, I don't have any extra risk factors. In the meantime, I'm going to mention any changes I notice in my breasts to my doctor.
Helen, 40
My friend was diagnosed with late-stage breast cancer after finding a lump in her breast when she was 48. She didn't have any risk factors for the disease, so she hadn't had any mammograms before then. I can't help but think that maybe if she'd had a mammogram a year or two before, the cancer may have been found earlier. I'm not at high risk for breast cancer either, but I’m going to keep having my yearly mammogram just to be sure nothing is wrong.
Sally, 46
I travel a lot for my job, and my days are often crammed with back-to-back meetings, so trying to schedule a mammogram is a challenge. But I've managed to do it, and all my mammograms have been normal. Now some doctors are saying that it's okay for women to wait and start having mammograms at 50. I think that's reasonable, and I don't feel like I would be putting myself at much greater risk for missing a cancer by waiting until I'm 50 to get my next one.
Bella, 44
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to start mammograms at age 40 (or anytime in your 40s)
Reasons to start mammograms at age 50
I'm worried that I might get breast cancer at an earlier age.
I'm not too worried that I might get breast cancer at an earlier age.
I think starting mammograms earlier is worth the increased risk of having a false-positive test result if it could find cancer early.
I think the chance of having a false-positive test result is more likely than the test finding a real problem if I start having mammograms earlier.
I'm not afraid to have a biopsy or other tests if my doctor sees a problem on the mammogram.
I don't want to have a biopsy or other tests that I may not need.
I'm not afraid of being exposed to small doses of radiation each time I have a mammogram.
I don't want to be exposed to any more radiation than is necessary.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Start mammograms at age 40 (or anytime in your 40s)
Start mammograms at age 50
Check the facts
Decide what's next
Certainty
1. How sure do you feel right now about your decision?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Author | Healthwise Staff |
---|---|
Primary Medical Reviewer | Adam Husney MD - Family Medicine |
Primary Medical Reviewer | Kathleen Romito MD - Family Medicine |
Primary Medical Reviewer | E. Gregory Thompson MD - Internal Medicine |
Primary Medical Reviewer | Wendy Y. Chen MD, MPH MD, MPH - Medical Oncology, Hematology |
This information is for women who are choosing to have screening mammograms and who are at average risk for breast cancer. It is not for women who are at high risk. If you don't already know your breast cancer risk, you can ask your doctor. Or you can go to www.cancer.gov/bcrisktool/ to look it up.
A mammogram is an X-ray of the breast that is used to look for breast cancer.
There are two types of mammograms.
This decision aid is about screening mammograms.
Mammograms can find some breast cancers early, when the cancer may be more easily treated. Often a mammogram can find cancers that are too small for you or your doctor to feel.
Studies show that a small number of women who have mammograms may be less likely to die from breast cancer.
The risk for breast cancer goes up as you get older. In general, women younger than 50 are at a lower risk for breast cancer. Because of this, women ages 50 to 70 are more likely to benefit from having a mammogram than women who are in their 40s.
Each time you have a mammogram, there is a risk that the test:
Ages 40–49 | About 19 out of 1,000 women |
---|---|
Ages 50–59 | About 30 out of 1,000 women |
Ages 60–69 | About 44 out of 1,000 women |
*Based on the best available evidence (evidence quality: moderate to high)
| Women who have mammograms | Women who don't have mammograms | Mammograms making a life-saving difference |
---|---|---|---|
Ages 40–49 | About 3 out of 1,000 will die of breast cancer | Between 3 and 4 out of 1,000 will die of breast cancer | For less than 1 out of 1,000 women |
Ages 50–59 | About 6 out of 1,000 will die of breast cancer | About 7 out of 1,000 will die of breast cancer | For about 1 out of 1,000 women |
Ages 60–69 | About 9 out of 1,000 will die of breast cancer | About 13 out of 1,000 will die of breast cancer | For about 4 out of 1,000 women |
*Based on the best available evidence (evidence quality: moderate to high)
Mammograms can find some breast cancers early, when the cancer may be more easily treated. Often a mammogram can find cancers that are too small for you or your doctor to feel.
Take a group of women who have a mammogram every year for 10 years.1
Studies show that a small number of women who have mammograms may be less likely to die from breast cancer. Since the risk for breast cancer goes up as you get older, women ages 50 to 70 are more likely to benefit from having a mammogram than women who are in their 40s.
Take a group of women who have a mammogram every year for 10 years.1
The numbers in the tables and narratives include women who are expected to be diagnosed with invasive breast cancer or an early form of noninvasive breast cancer called ductal carcinoma in situ.
| Number of women who will have at least one false-positive that results in more testing (but turns out not to be cancer) | Number of women who will have a biopsy they don’t need |
---|---|---|
Ages 40–49 | About 613 out of 1,000 women | About 70 out of 1,000 women |
Ages 50–59 | About 613 out of 1,000 women | About 94 out of 1,000 women |
Ages 60–69 | About 497 out of 1,000 women | About 98 out of 1,000 women |
*Based on the best available evidence (evidence quality: moderate to high)
Mammograms may show an abnormal result when it turns out there wasn't any cancer (called a false-positive). This means you may need more tests—such as another mammogram, a breast ultrasound, or a biopsy—to make sure you don't have cancer. These tests can be harmful and cause a lot of worry.
Take a group of women who have a mammogram every year for 10 years.1
Breast cancer screening can also lead to unnecessary biopsies.
Take a group of women who have a mammogram every year for 10 years.1
Mammograms may find cancers that would never have caused a problem if they had not been found through screening (called over diagnosis). But a mammogram can't tell whether the cancer is harmless. So you may get cancer treatment that you don't need.
Out of 1,000 women who are diagnosed with breast cancer during screening mammograms, experts estimate that about 190 of them may get treatment they don't need.1
The numbers in the tables and narratives include women who are expected to be diagnosed with invasive breast cancer or an early form of noninvasive breast cancer called ductal carcinoma in situ.
Some evidence is better than other evidence. Evidence comes from studies that look at how well treatments and tests work and how safe they are. For many reasons, some studies are more reliable than others. The better the evidence is—the higher its quality—the more we can trust it. The information shown here is based on the best available evidence.1 The evidence is rated using four quality levels: high, moderate, borderline, and inconclusive.
Another thing to understand is that the evidence can’t predict what's going to happen in your case. When evidence tells us that 2 out of 100 people who have a certain test or treatment may have a certain result and that 98 out of 100 may not, there's no way to know if you will be one of the 2 or one of the 98.
Experts agree that mammograms are the best screening test for women at average risk. But they don’t all agree on the age at which a woman should start or whether it is better for her to be screened every year or every two years.
Here are some of the recommendations from experts:
When to stop having mammograms is another decision. You and your doctor can decide on the right age to stop screening based on your personal preferences and overall health.
Start mammograms at age 40 | Start mammograms at age 50 | |
---|---|---|
What is usually involved? |
|
|
What are the benefits? |
|
|
What are the risks and side effects? |
|
|
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"No one in my family has ever had breast cancer. So I'm not at high risk for getting it. I talked with my doctor about this, and I read all of the information I could. My doctor says it's my decision, but she is here to answer any questions and talk it over. I'm worried about false positives. I have a friend who has had two biopsies, and many sleepless nights, and it turned out to be nothing. I'm having a tough time deciding. I think for me the best decision is no decision. I'll keep reading and thinking about it. I’m okay with this."
— Keiko, 41
"I’ve already talked to my doctor about getting a mammogram when I turn 40 next year. Taking action is really important to me when it comes to my health. My older sister started having mammograms when she turned 40. She got a call once because they found something on her mammogram, but after more testing it turned out to be nothing serious. I want to have that reassurance—the peace of mind is worth it to me."
— Jaime, 39
"I'm not really worried about getting breast cancer, so I've decided to wait until I'm 50 to start having mammograms. I just turned 40, and I've always been healthy and active. Plus, I don't have any extra risk factors. In the meantime, I'm going to mention any changes I notice in my breasts to my doctor."
— Helen, 40
"My friend was diagnosed with late-stage breast cancer after finding a lump in her breast when she was 48. She didn't have any risk factors for the disease, so she hadn't had any mammograms before then. I can't help but think that maybe if she'd had a mammogram a year or two before, the cancer may have been found earlier. I'm not at high risk for breast cancer either, but I’m going to keep having my yearly mammogram just to be sure nothing is wrong."
— Sally, 46
"I travel a lot for my job, and my days are often crammed with back-to-back meetings, so trying to schedule a mammogram is a challenge. But I've managed to do it, and all my mammograms have been normal. Now some doctors are saying that it's okay for women to wait and start having mammograms at 50. I think that's reasonable, and I don't feel like I would be putting myself at much greater risk for missing a cancer by waiting until I'm 50 to get my next one."
— Bella, 44
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to start mammograms at age 40 (or anytime in your 40s)
Reasons to start mammograms at age 50
I'm worried that I might get breast cancer at an earlier age.
I'm not too worried that I might get breast cancer at an earlier age.
I think starting mammograms earlier is worth the increased risk of having a false-positive test result if it could find cancer early.
I think the chance of having a false-positive test result is more likely than the test finding a real problem if I start having mammograms earlier.
I'm not afraid to have a biopsy or other tests if my doctor sees a problem on the mammogram.
I don't want to have a biopsy or other tests that I may not need.
I'm not afraid of being exposed to small doses of radiation each time I have a mammogram.
I don't want to be exposed to any more radiation than is necessary.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Start mammograms at age 40 (or anytime in your 40s)
Start mammograms at age 50
1. Does the risk of breast cancer go up as you get older?
2. Can having mammograms help save lives?
3. If your mammogram shows an abnormal result, does that mean you have breast cancer?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
By | Healthwise Staff |
---|---|
Primary Medical Reviewer | Adam Husney MD - Family Medicine |
Primary Medical Reviewer | Kathleen Romito MD - Family Medicine |
Primary Medical Reviewer | E. Gregory Thompson MD - Internal Medicine |
Primary Medical Reviewer | Wendy Y. Chen MD, MPH MD, MPH - Medical Oncology, Hematology |
Current as of: September 8, 2021
Author: Healthwise Staff
Medical Review:Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine & Wendy Y. Chen MD, MPH MD, MPH - Medical Oncology, Hematology
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