At what age women should get mammograms and how often has been a controversial topic. The American Society of Breast Surgeons recommends that women should discuss screening mammography with their physicians, who can help decide if they are at average, intermediate, or high risk for developing breast cancer in their lifetime. Women at average risk for developing breast cancer may consider starting screening mammograms at age 40-44; however, all average-risk women should start annual screening mammograms no later than age 45. After 55, average-risk women may get screening mammograms every year or every other year, depending on their shared decision with their personal doctors. Once a woman has reached age 75, if she is expected to live more than 10 years, screening mammograms may be obtained every other year. For those women who are at high risk for developing breast cancer, yearly screening mammograms are recommended beginning at age 40. For additional guidance, review our News Article on Screening Mammography.
Do you need an MRI? Generally, you should talk to your doctor about the merits of this test in your particular case. You should know that a breast MRI will not replace your mammogram. The following are examples of some situations in which this type of imaging is used:
If you have a lymph node in your armpit that shows cancer but your mammogram is normal, an MRI may find a cancer in the breast that was not be detected by a mammogram.
If you have been diagnosed with breast cancer and your mammogram is difficult to interpret (either due to dense breast tissue or other issues), your doctor may recommend an MRI to determine how extensive the disease is within that breast, as well as to look for breast cancer in the other breast.
If you have had chemotherapy before surgery, your doctor may use MRI to assess your response to the chemotherapy and better plan your surgery
If you have a BRCA 1 or 2 gene mutation, or a very high risk of developing breast cancer (greater than 20% chance in your lifetime based on risk assessment models), or you have had a history of radiation therapy to your chest before 29 years of age, an annual MRI is recommended as part of your breast cancer screening.
If you do need an MRI, your doctor should ensure that it is done at an appropriate facility that has the necessary equipment and personnel to yield meaningful results. And it is important, whenever possible, to have the MRI coordinated around specific times of the menstrual cycles in women who still menstruate. This is because MRI results may vary with hormonal changes of the menstrual cycle.