Breast Cancer Screening for High Risk and Average Risk Women


The Breast Center recommends that most women begin receiving annual screening mammograms starting at age 40; this results in the most life-years saved. Guidelines from the American Society of Breast Surgeons support yearly mammograms for women starting at 40 years of age, and recommends the use of 3D mammography.

Guidelines from the American Society of Breast Surgeons support annual screening mammograms for women beginning at age 40. Click To Tweet

American Society of Breast Surgeons position on screening mammography

According to the guidelines from the American Society of Breast Surgeons (ASBrS), breast cancer risk assessment should begin at age 25, or when first seen by a breast physician.

As a general rule, women should start screening mammograms at 40. However, each woman has different health needs and a different risk for breast cancer. Women at above average risk who are treated as though they are at an average risk for breast cancer won’t receive the care that they need. This is why risk assessment is critical.

The ASBrS guidelines also state that women at a higher risk for breast cancer should consider annual MRI at 25 and annual screening mammography starting at age 30. Women at a higher risk for breast cancer could include:

  • those with a family history of malignancies,
  • a history of atypical hyperplasia or lobular carcinoma in situ (LCIS),
  • or history of chest or mantle radiation therapy between the ages of 10 and 30.

Establishing a breast cancer screening plan

The Breast Center continues to recommend annual screening mammograms for women with average risk beginning at 40 years of age. Several health organizations agree:

  • American Cancer Society
  • National Cancer Institute
  • American Medical Association
  • Society for Breast Imaging
  • American College of Radiology

Dr. Pat Whitworth, co-chair of the ASBrS panel that established the new guidelines told Reuters Health, “Everyone agrees that the most life-years saved obtain if screening starts at 40, even those who recommend starting later. Their objections are based on anxiety and negative biopsies and overdiagnosis [finding a cancer that would not harm the patient in her lifetime].”

Every woman should understand her relative risk and absolute risk for breast cancer. Taking a Breast Cancer Risk Quiz is a good place to start. It’s important to speak to a healthcare professional who can help you understand your risk of breast cancer, and identify the best screening method for you.