When to Get a Mammogram

In the U.S., a number of medical organizations have published guidelines on using mammograms to screen for breast cancer. The organizations give varying recommendations on the age at which women should start getting mammograms and how often to get them, making it somewhat confusing to know what the “official” guidelines are.

Many experts, and several major medical societies, recommend that women who are at average risk of breast cancer get screening mammograms every year starting at age 40.

This is the recommendation of the American College of Radiology, the Society of Breast Imaging, the American Society of Breast Surgeons, and the National Comprehensive Cancer Network.

Some experts argue that getting a mammogram every year can lead to greater expense, unnecessary testing, and more false positives. (A false positive is when a mammogram detects an area that appears abnormal but turns out, after additional testing, not to be cancer.)

These concerns have led several medical organizations to recommend that women at average risk be offered mammograms starting at age 40, but that specific decisions about when to start and how often to get mammograms should be made on an individual basis in collaboration with their doctor. And others, like the U.S. Preventive Services Task Force (USPSTF) in its 2024 recommendations, propose that women at average risk should start mammograms at age 40 and have a mammogram every other year.

Advocates of annual mammograms point out that some breast cancers grow fast and that yearly testing is important for catching cancer as early as possible for the best outcome.

Some women have risk factors that put them at higher-than-average risk for developing breast cancer. The American College of Radiology, the National Comprehensive Cancer Network, and several other medical organizations have published screening guidelines for these women. The recommendations vary depending on individual risk factors. But in general, they recommend annual mammograms starting at age 30 and annual breast MRIs starting at age 25 to 35.

The best way to find out your individual risk for breast cancer is to ask your primary care doctor or gynecologist to do a risk assessment or to refer you to a breast clinic for evaluation.

The American College of Radiology recommends that all women, but especially Black women and women of Ashkenazi Jewish descent, be evaluated by a doctor to find out if they’re at higher-than-average risk for breast cancer no later than age 25. 

If you've had a mammogram in the past and your mammogram report showed that you have dense breast tissue, talk with your doctor about whether you should get ultrasounds and/or breast MRIs, in addition to mammograms. Women with dense breast tissue are at slightly higher risk for breast cancer than those whose breast tissue is not dense. Also, dense breasts make it harder for doctors to see breast cancer on mammograms. This increases the risk that breast cancers may not be detected using mammograms alone.

Although the research is limited, current studies suggest that transgender men and women who have breast tissue have a higher breast cancer risk than that of cisgender men, though it’s much lower than the risk for cisgender women. As such, medical experts recommend that they receive regular mammograms to screen for breast cancer.

Here again, however, there’s disagreement among medical professionals about when members of the transgender community should get mammograms. This is due to a lack of research on breast cancer screening for transgender people.

If you’re a trans man or non-binary person who was assigned female at birth (afab), whether you should get a mammogram depends primarily on age, risk factors unrelated to gender, and possibly whether you’ve had chest masculinization surgery (though this last factor is contested between groups of medical experts).

If you’re a transgender woman or non-binary person who was assigned male at birth (amab), whether you should get a mammogram depends on your age; whether you’re receiving feminizing hormone therapy and if so, for how long; and risk factors unrelated to gender.

Mammograms for transgender people who need them should be provided annually — at the same frequency as for cisgender women.

Men have a small amount of breast tissue and can develop male breast cancer, though it's rare. For most cisgender men, regular screening mammograms are not recommended.

Some men have a higher-than-average risk of developing male breast cancer because they have an inherited mutation in the BRCA1 or BRCA2 gene, a strong family history of breast cancer, or other risk factors. And some research shows that mammograms can be beneficial for these men.

The National Comprehensive Cancer Network (NCCN)’s guidelines currently recommend that men with a BRCA1 or BRCA2 gene mutation consider getting annual screening mammograms. These should start either at age 50 or 10 years before the earliest known male breast cancer diagnosis in the family — whichever comes first. However, if you’re a man who is concerned about your breast cancer risk, you should talk with your doctor about a screening plan that makes sense for your unique situation.

If you’ve had surgery for breast cancer (a lumpectomy or mastectomy) or a prophylactic (preventive) mastectomy, ask your doctor if you still need to get mammograms or other types of breast imaging for ongoing breast cancer screening, and, if so, what they recommend for a screening plan. In most cases, you won’t need to continue having mammograms if you had a double mastectomy. If you had a single mastectomy, mammograms of the unaffected breast are still needed. If you had a lumpectomy, your doctor will usually recommend that you continue to get annual screening mammograms. Learn more about mammograms after different types of breast surgery.

Different health organizations recommend different things for people over 74. Ultimately, if you’re older than 74 and would want to be treated for breast cancer, if any were found, you may decide to continue getting mammograms.

The American College of Radiology and the Society of Breast Imaging recommend annual mammograms for people who have never had breast cancer, are at average risk for the disease, and are over the age of 74.

Other guidelines recommend talking with your doctor about your individual situation and whether or not you should continue getting screening mammograms every year. For example, the American Cancer Society says that women should continue getting mammograms as long as they are in good health and expect to live at least 10 more years. The USPSTF's 2024 mammogram recommendations, on the other hand, say there isn't enough scientific evidence to assess the benefits and harms of mammograms in women aged 75 and older.

It’s a good idea to have a conversation with your doctor about the risks and benefits of breast cancer screening, your health, and your personal preferences, so you can make an informed decision about whether to continue getting screening mammograms.