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Breast Imaging

Who Needs a Mammogram?

We recommend starting annual mammography at age 40 for women who are at average risk of developing breast cancer. This is the policy of Siteman Cancer Center and Washington University School of Medicine. It’s also the recommendation of the American College of Radiology, the Society of Breast Imaging and the National Comprehensive Cancer Network (NCCN), which is a group of the nation’s leading cancer centers.

Research shows that women who receive annual mammograms beginning at 40 are likely to derive the most lifetime benefit from the screenings. We also urge all women to talk with their health care providers about their family medical history and other risk factors for breast cancer because women with a higher-than-average risk will need additional screening strategies.

Below are our overall recommendations for average risk women:

  • Mammograms: Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
  • Clinical breast exam: Clinical breast exams should be part of a periodic health exam - about every three years for women in their 20s and 30s and every year for women over 40 and over.
  • Breast awareness and breast self-exam: Women should know how their breasts normally feel and report any breast changes promptly to their health care providers. Breast self-exams are an option for women starting in their 20s.
  • Breast magnetic resonance imaging (MRI): Screening MRI is recommended for women with an approximately 20-25% or greater lifetime risk of breast cancer, including women with a strong family history of breast or ovarian cancer and women who were treated for Hodgkin’s disease.

We acknowledge that controversy about screening mammography still prevails despite an abundance of research that affirms its efficacy in reducing breast cancer death. No medical test is perfect, and mammography is no exception. Likewise, “low” risk does not mean “no risk.”

Here’s a link to a televised interview with one of our expert breast imaging doctors discussing the new screening mammography guidelines and our policy.