I'm Doctor Monique Gary, breast surgical oncologist in Bucks County, Pennsylvania.
There are many different recommendations for when breast cancer screening should start.
Early detection should start, according to the National Comprehensive Cancer Network (NCCN), or the cancer bible that most cancer doctors use, recommends starting annual early detection for people at average risk at age 40. And we recommend they start at age 40 and get imaging every single year.
There are other guidelines that your doctors may know of. The U.S. Preventive Services Task Force, for example, says women of average risk should start at age 40 and get screened every other year.
Unfortunately, there's a lot of controversy around screening, so it's really important for you to talk to your doctor about it and make sure you take that family history with you because family history trumps everything.
How many of us have ever had a risk assessment to know if you're average risk? There are calculators that you can use, and what you should do is talk to your doctor and go to your primary care or your gynecologist. Bring your family history and ask for a risk assessment. They're able to do some math and put in that family history and figure out, ‘Are you at average risk or are you at elevated risk?' If you're an elevated risk, you might meet criteria for screening twice a year. And so, it's super important to know that history.
Unfortunately for young women, there are no guidelines for women under the age of 40 unless you have that family history. And that's why it's so important to know.
But for young women who are concerned about their breast health, the most important thing you can do is practice breast self-awareness — know thyself, know your body, know your family history — and do everything you can — whether it's your meals, your movement, your mindfulness — to reduce your risk for development of breast cancer.
And if you feel something and if you're not sure what you're feeling, go to your doctor and get some imaging. That's what young women should do.
Now, when should you stop screening? Well, that's a really good question.
There are a lot of conflicts around that, too. But in general, the American Society of Breast Surgeons and the NCCN insist that a woman should stop screening when her life expectancy is less than 10 years or so. So, if grandma is 92 and still putting on lipstick and still driving, grandma might want to get that mammogram. And if you've got folks in your family that live to be 100 years old, then you may want to make sure you get that mammogram, as well.
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