Breast Cancer Screening
Breast cancer screening can detect cancer before signs or symptoms develop. While breast cancer screening cannot prevent breast cancer, it can help find breast cancer in its earliest and most treatable stage. When detected in the localized (early) stage, breast cancer has a 5-year relative survival rate of 99%, according to the American Cancer Society.
Regardless of your risk of breast cancer, it is important to talk with your healthcare provider about the best screening tests, recommendations, and timelines for screening.
Table of Contents
Use these links to jump to the breast cancer screening information you need:
What is Breast Cancer Screening?
Breast Cancer Screening Recommendations
Breast Cancer Screening Tests
Breast Cancer Diagnostic Tests
Benefits and Risks of Breast Cancer Screening
Breast Cancer Screening for Men
Breast Cancer Screening Facts
Breast Cancer Screening FAQs
What is Breast Cancer Screening?
Breast cancer screening can detect breast cancer before it has spread and before there are symptoms to help reduce the number of people who die from cancer. Screening can also identify those who may need more frequent or additional tests to check for breast cancer.
There are different types of breast cancer screening tests, as well as different age recommendations to begin screenings. The different tests and recommendations are listed below, and you can also check with your doctor to determine which screenings are right for you and at what ages.
The more you know about breast cancer screening, the more you can take charge of your breast health.
Breast Cancer Screening Recommendations
The U.S. Preventative Services Task Force states that women should start receiving mammograms at the age of 40. However, women at higher risk of developing breast cancer may benefit from beginning regular mammography earlier than the age of 40. Family health history can inform the decision to undergo earlier breast cancer screening.
Below are general breast health screening recommendations for women at average risk of breast cancer. Please consult with your healthcare provider on when is the best time for you to begin breast health screenings based on your specific situation and any risk factors that may be present.
| Women ages 20+ | Annual breast exam as part of medical check-up or well-woman exam |
| Women ages 20+ | Monthly breast self-exam for all pre- and postmenopausal women |
| Women ages 40+ | Annual mammogram for women of average breast cancer risk |
High Risk Breast Cancer Screening
Women at higher risk for breast cancer can benefit from screening at an earlier age, as well as from annual breast MRIs in addition to mammography. The American Cancer Society recommends most women at high risk begin screening at age 30, or upon your doctor’s recommendation.
Your doctor can help you assess if you are at higher risk of developing breast cancer. Risk factors include a personal or family history of breast cancer, a BRCA1 or BRCA2 inherited gene mutation, previous radiation to the chest area, and other gene mutations or health conditions.
In addition, breast cancer screening for dense breasts can be more challenging. The Food and Drug Administration (FDA) now requires mammogram providers to notify women if they have dense breast tissue and recommend consultation with a healthcare provider on potential additional screening, since dense breast tissue can make it more difficult to spot breast cancer.
Breast cancer screening after mastectomy is not needed on the side of the body where breast tissue was removed; breast cancer screening after double mastectomy should no longer be required since there likely won’t be enough breast tissue remaining for a mammogram.
Talk with your doctor or healthcare provider to assess breast cancer risk and determine the best age for you to begin breast cancer screening.
Breast Cancer Screening Tests
Although there are several types of breast cancer screening tests available, mammography is the most common and most accurate form of screening.
Breast Self-Exam
A breast self-exam involves looking at and feeling your breasts for potential lumps or swelling. If you are familiar with how your breasts typically look and feel, you will be more likely to notice any changes.
A breast self-exam should be performed once a month by all women. Premenopausal women should perform their self-exam the week after their cycle. Postmenopausal women should choose a consistent time each month to perform their self-exam.
While the majority of breast lumps are not breast cancer, all breast lumps should be investigated by a healthcare professional. If you’re not sure how to perform a breast self-exam, download the Know the Symptoms Guide for instructions.
Clinical Breast Exam
During a clinical breast examination, a healthcare professional carefully looks and feels for any differences in breast shape and size, as well as lumps, dimpling, rashes, or anything else unusual. Clinical breast exams are often performed during your annual medical check-up or well-woman exam, beginning around the age of 20.
Mammogram
A low-dose x-ray of the breasts, mammograms are the best way to find breast cancer in its early stages. Mammograms can often find breast cancer or breast changes long before symptoms develop. If something is detected on an annual mammogram, typically known as a screening mammogram, additional tests, such as a diagnostic mammogram, will likely be ordered.
Mammograms are performed with a machine that has two plates that compress the breast and spread the tissue apart, providing a clearer picture of the breast.
2D screening mammography, which typically takes one picture of the breast from the side and one from above, was the standard for many years.
Today, 3D mammograms, also known as digital breast tomosynthesis, are more common and more accurate at detecting breast cancer. They also work well for women with dense breast tissue and reduce the need for follow-up screening. A more advanced type of imaging, a 3D mammogram takes multiple images of the breast from different angles. Not every insurance plan covers 3D mammography, although more are now doing so.
NBCF offers a free Mammogram 101 resource that helps you prepare for your mammogram.
Breast Cancer Diagnostic Tests
MRI
A breast MRI uses radio waves and magnets to take pictures of the breast and may be used in conjunction with mammograms for women at higher risk of breast cancer or those who have dense breast tissue. Likewise, if your initial breast screening exam is not conclusive, your doctor may order an MRI to take a closer look.
Breast MRI imaging creates detailed pictures of specific areas within the breast that can help your medical team distinguish between normal and potentially cancerous tissue.
Ultrasound
Sometimes used in conjunction with other breast cancer screening tests, a breast ultrasound uses sound waves to view the inside of the breasts. The ultrasound generates a picture called a sonogram, which can help measure the size and location of a lump and determine if it is a cyst, which is not typically cancerous, or a cancerous tumor.
Genetic Screening
Genetic screening for breast cancer scans for mutations in the BRCA1 and BRCA2 genes. Some people inherit mutations in these genes, which can increase their risk of breast cancer as well as ovarian and pancreatic cancer.
Women with a family history of breast cancer are also at higher risk of getting breast cancer; however, most women with a family history of breast cancer do not have an inherited gene that increases their risk. It is important to weigh the pros and cons of genetic testing and screening with your family and doctor. To keep track of your family medical history to share with family members and your healthcare team, use NBCF’s free Family Medical History Checklist.
Benefits and Risks of Breast Cancer Screening
As with many medical tests, there are both benefits and risks. However, the benefits of breast cancer screening far outweigh the risks.
Benefits of Screening
The most significant benefit of breast cancer screening is reduced mortality. Women who receive annual mammograms from the ages of 40 to 84 experience a 40% lower breast cancer mortality rate than women with no screenings, according to research. Mammograms also decrease the number of women diagnosed with cancer in a later stage, when it is more difficult to treat and more likely to have spread.
Regular breast cancer screening also decreases healthcare costs, since cancer diagnosed at an earlier stage is usually less expensive to treat. Finally, breast cancer screening can provide peace of mind and a reminder of the importance of focusing on overall health and wellness.
Risks of Screening
The chief risk of screening is a false positive result, and the anxiety that may cause. A false positive is when something may initially look like cancer, but turns out not to be cancer upon further examination. Initial false-positive results may lead to additional testing, such as a biopsy, and can create unwarranted anxiety.
However, with recent advancements in mammogram technology, radiologists consider the risk of a false positive to be relatively small. The general consensus is that most women and doctors are willing to risk the small chance of a false positive over missing something suspicious found on a routine mammogram.
Radiation can be risky for women who are pregnant. Pregnant women should always let their doctor or x-ray technician know that they are expecting since pregnant women should limit or forgo any screenings or treatments involving radiation.
While no screening test is 100% accurate, regular mammograms have been repeatedly shown to significantly reduce the risk of dying from breast cancer.
Breast Cancer Screening for Men
Currently, there are no guidelines on screening men for breast cancer, and male breast cancer remains extremely rare, representing less than 1% of all breast cancer cases.
It is generally easier for men and their healthcare providers to feel a breast tumor since men have little breast tissue, yet men with breast cancer have a higher mortality rate than women due to lower awareness and likelihood of seeking treatment. Breast exams and occasionally mammograms and ultrasound may be appropriate for men who have a strong family history of male or female breast cancer or who have BRCA gene mutations.
Breast Cancer Screening Facts
In the United States, 1 in 8 women will develop breast cancer in her lifetime. It is the second most common type of cancer for women, following skin cancer.
About 65% of breast cancer cases are diagnosed in the localized stage, before the cancer has spread outside of the breast. The 5-year relative survival rate for breast cancer detected at this stage is 99%, which is why awareness and regular screenings are so critically important.
Unfortunately, there are notable disparities in breast cancer screening. Nearly half of uninsured women delay or go without care due to costs. In addition, the death rate for breast cancer among Black women is 40% higher than it is for white women, and it is the leading cause of cancer death for Hispanic women in the United States.
National Breast Cancer Foundation shares the latest statistics on breast cancer and breast cancer disparities. In addition, NBCF’s National Mammography Program provides resources on free mammograms and diagnostic services.
Breast Cancer Screening FAQs
When should you start screening for breast cancer?
Well-woman exams, which can include clinical breast exams, and Pap tests are recommended starting at age 20.
Mammograms are recommended starting at age 40 for women of average breast cancer risk. However, if you have a significant family history of breast cancer, such as one or more first-degree relatives diagnosed with breast cancer, or a first-degree relative diagnosed under the age of 50, then you may need to begin screening earlier. For example, if a mother was diagnosed with breast cancer at age 42, her biological daughter would likely benefit from breast cancer screening beginning at age 32. Talk with your healthcare provider about the best schedule for mammograms.
What are the screening tests for breast cancer?
In addition to mammograms, which are the best screening tests for finding breast cancer in its early stages, other screening tests for breast cancer include breast self-exams and clinical exams. Other forms of imaging studies for screening include ultrasounds and breast MRIs.
Can men get breast cancer?
While it is rare, men do get breast cancer. In 2023, an estimated 2,800 men will be diagnosed with breast cancer, according to the American Cancer Society. Men diagnosed with breast cancer may be encouraged to undergo genetic counseling and genetic testing to see if they carry a BRCA1 or BRCA2 gene mutation. The most common gene mutation for men is BRCA2.
What is the risk of radiation from mammograms?
Mammograms require very small doses of radiation, lower than that of a typical x-ray. The total radiation for a typical mammogram is about 0.4 millisieverts—the same amount women are exposed to in their natural environment in about seven weeks. Studies consistently show that the benefits of receiving mammograms outweigh the risks of radiation exposure for most women. However, always let your healthcare provider know if you are pregnant or could be pregnant as radiation exposure risk for pregnant women is higher.
Sources:
American Cancer Society
Centers for Disease Control and Prevention
National Cancer Institute
U.S. Preventative Services Task Force