Mammograms: What You Should Know

A manual breast exam can't always detect abnormal changes to your breasts. For that, you'll need a mammogram and possibly other advanced imaging that lets your physician take a good look at your breast tissue.

What is a mammogram?

Mammograms are low-dose X-rays of your breasts. They allow your physician to identify abnormal changes in your breast tissue that cannot be felt during an external manual exam.

When combined with a clinical breast exam done by your physician, a mammogram is the most effective way to identify breast cancer in its earliest stages. And the earlier breast cancer is found, the better your chance of a successful outcome.

Mammograms are used for screening and diagnosis.

Screening mammograms are used when you don’t have signs of breast cancer.
Diagnostic mammograms are used after a lump is detected or you experience other warning signs such as breast pain, discharge or changes in shape or size of your breasts.

The same technology is used for both but a diagnostic mammogram may take longer than a screening mammogram because more X-rays are required to make a diagnosis.

Advanced Imaging Technology

Advanced technology makes it possible to obtain more detailed images in a format that’s easy to store, access and share.

Breast Magnetic Resonance Imaging (MRI) uses magnets and radio waves to create detailed 3D images of your breast tissue.
Breast ultrasound uses high-frequency sound waves for a non-invasive view of your breast. It’s an effective way to find cancer in women with dense breasts and may eliminate the need for a biopsy in some cases.
3D mammography uses low-dose X-rays to produce computer-generated images of your breast tissues. It provides detailed, clear images to reveal cancers that would otherwise be too small to see.
Molecular breast imaging uses a special camera and radioactive tracer to identify cancer cells. Your physician may recommend molecular breast imaging if you have dense breasts.

American Cancer Society Guidelines

Guidelines from the American Cancer Society (ACS) detail the recommended schedule for scheduling your first mammogram and all the others that follow. The recommendations vary depending on whether you’re at average or high risk.

Talk with your physician about the screening schedule you should follow.

Average Risk

You are considered to be at average risk if you:

Do not have a genetic mutation such as the BRCA gene known to increase the risk of breast cancer.
Have not had chest radiation therapy before turning 30.
Have no personal or strong family history of breast cancer. A strong family history means you have one or more first-degree relatives—your mom, sister or daughter—who have been diagnosed with breast cancer.

The recommended screening schedule if you’re a woman with average risk is:

Ages 40–44 have the option to start annual mammogram screenings.
Ages 45–54 should get an annual screening mammogram.
Ages 55 and older should have a screening mammogram every year or every other year, depending on their preference and physician’s recommendation.

Screenings should continue as long as you're in good health and have a life expectancy of at least 10 years.

High Risk

You are considered at high risk for breast cancer if you:

Had radiation therapy between the ages of 10 and 30 years old.
Have a confirmed BRCA1 or BRCA2 gene mutation based on testing.
Have a first-degree relative with BRCA1 or BRCA2 gene mutation but have not had genetic testing yourself.
Have Cowden syndrome, Li-Fraumeni syndrome or Bannayan-Riley-Ruvalcaba syndrome or have one or more first-degree relatives with one of these syndromes.

If you’re considered high risk, the ACS recommends you add a breast MRI to your screening mammogram each year, beginning at age 30. A breast MRI should not replace your screening mammogram. Instead, the two should be used together as part of your annual wellness routine.

You should continue getting both types of screenings as long as you are in good health.