Screening Under Age 40

Last Modified: May 7, 2006

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Dear OncoLink "Ask The Experts,"

What can you tell me about testing for breast cancer under the age of 40?


Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:

Many women are now getting baseline mammograms at age 35, then another at 40 years old to start the annual ritual. At that age, the breast tissue is very dense, making it difficult for the radiologist to interpret. The younger the woman, the more dense the tissue. Many of these women will get called back for extra pictures because of this difficulty, and because typically there are no prior pictures with which to compare. Other tests that are used in young women if something is suspected are breast MRIs and ultrasound, but these are not typically used for screening. Screening in young women should also include breast self-exam and an annual breast exam by a healthcare provider.

It is also important to remember that about 10% of women (all ages) will be called back to have repeat mammograms or ultrasound to clarify something seen on the first test. This number is higher in younger women (particularly those below 40) and those having their first mammogram (at any age). This is because the density of the breast tissue and the lack of a previous film to compare to make it more difficult for the radiologist to read, as stated earlier. Of the 10% of women who return for a repeat mammogram, only 8-10% of them will need a biopsy, and about 80% of all breast biopsies turn out to be benign. Essentially, only approximately 3 out of every 1000 mammograms lead to a cancer diagnosis.

Annual Mammography Screening Should Begin at 40

Jul 22, 2011 - Annual mammography screening for breast cancer in women should begin at age 40 years, and not at age 50 as previously recommended, according to the American College of Obstetricians and Gynecologists' Practice Bulletin on Breast Cancer Screening, published in the August issue of Obstetrics & Gynecology.

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