About UCSF Search UCSF UCSF Medical Center

Customize Starting Age and Frequency of Mammograms

By Elizabeth Fernandez, Public Affairs | July 7, 2011

Mammograms should not be done on a one-size fits all basis, but instead should be personalized based on a woman’s age, the density of her breasts, her family history of breast cancer and other factors including her own values. That’s the conclusion of a new study in the July 5 issue of the Annals of Internal Medicine.

The study challenges current guidelines from groups such as the American Cancer Society and the U.S. Preventive Services Task Force that make recommendations based on age alone. The American Cancer Society recommends annual screening starting at age 40 with no upper age limit, while the U.S. Preventive Services Task Force recommends biennial screening for women between the ages of 50 and 74.

While mammography screening indisputably decreases deaths from breast cancer, there is disagreement as to when women should begin mammography and how often they should get it: every two years starting at 50 or every year starting at 40?

“Our analysis suggests that women with a first-degree relative with breast cancer or with a history of a breast biopsy should have an initial screening mammography at age 40,” said study co-author Karla Kerlikowske, MD, MS, an expert in mammography at the University of California, San Francisco.

“For women age 40 to 49 with high breast density, and with either a first-degree relative with breast cancer or a prior breast biopsy, the benefits versus harm for performing mammography every two years is similar to screening an average-risk woman in her 50s. This amounts to about 20 percent of women in their 40s. For women age 40 to 49 without these risk factors, it is reasonable to wait until age 50 to start mammography screening.”

Read more at Elizabeth Fernandez, Public Affairs