Breast cancer screening recommendations


Breast cancer is the second leading cause of cancer death in American women.* However, the promising news is that most women who are diagnosed with breast cancer at an early stage survive their cancer and continue to live normal lives.

Factors that place you at higher risk for breast cancer are:

  • Age. As you age, your chance of getting breast cancer increases.
  • Alcohol consumption. Drinking wine, beer, or hard liquor has been shown to increase a woman's chance of getting breast cancer. On average, consumption of more than two alcoholic beverages a day is consistently associated with an increased risk.
  • Being overweight. Women who are post-menopausal and overweight are at increased risk of developing breast cancer.
  • Ethnic or racial background. Caucasian women have the highest risk, followed by African-American and Hawaiian women. Hispanic-American and Asian-American women appear to have the lowest risks. Woman of Ashkenazi Jewish descent are more likely to have a harmful mutation in the BRCA1 and BRCA2 genes than the general population, which increases the likelihood of developing breast cancer.
  • Family history of breast cancer. If you have a mother, sister, or daughter who has had breast cancer, you are at increased risk for the disease. A family history of breast cancer on your father's side is equally important as your mother's side. If you have a strong family history, you may be referred to our Center for Genetics and Prevention for further counseling and consideration of genetic testing.
  • Hereditary factors. Multiple relatives with breast cancer or ovarian cancer, especially if they were diagnosed when young, may suggest inherited breast cancer risk. However, only 5 to 10 percent of breast cancer is associated with a gene that can be identified.
  • Hormone replacement therapy. The use of hormone replacement therapy in the form of estrogen and progesterone for more than a limited duration (one to two years) places you at a somewhat higher risk for breast cancer.
  • Not having children or having children later in life. If you never have given birth or have delivered your first child after age 30, you are at increased risk.
  • Previous cancer treatment. A history of therapeutic radiation, especially to the chest area for treatment of Hodgkin lymphoma or other lymphomas, increases your risk.
  • Previous findings. If you have previously had breast cancer or a breast biopsy that showed premalignant changes, you may be at increased risk for breast cancer.
  • Reproductive health history. Long-term exposure to estrogen affects your risk of breast cancer. You are at higher risk if you had your first period before age 12 or reached menopause after age 55.

Screening recommendations

These recommendations apply to women of average risk who do not have a gene mutation, strong family history of breast cancer, or other major risk factors. Regardless of risk, women of all ages should be seen by their physician on a regular basis as part of general screening.

Ages 18-40: Physician exam at annual physical; mammogram is usually not needed.

  • If you have a significantly elevated risk level, mammogram screening at a younger age and the use of MRI screening may be warranted.
  • If you have a strong family history of breast cancer, screening usually starts five to 10 years before the youngest person in your family with the disease was diagnosed.

Ages 40-49: Physician exam at annual physical. The benefits of mammogram screening remain controversial since it is not clear that the benefits outweigh the risks for all women. You should make the decision to pursue mammography screening every one to two years based on your personal preference, your level of risk, and a discussion with your health care provider.

Ages 50+: Physician exam at annual physical; mammogram every one to two years.

It's important to discuss your risk with your health care provider and make a plan for prevention together.

If you believe you are at high risk, speak to your doctor or be seen at our Center for Cancer Genetics and Prevention to determine which types of cancer screening tests are best for you, and how often you should be screened.

*Breast cancer can arise in men but there are fewer than 200 cases a year. If you're a man with a breast abnormality you should talk to your doctor. 

Related links

Learn about Dana-Farber's Breast Oncology Program.

Find out about how we manage people at higher risk for breast cancer.

Find out about our metastatic breast cancer expertise.

Ask the expert about therapies for breast cancer.

Watch a video about DCIS and its treatment.


 
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