Mammogram screening to detect breast cancer should now start at 40, panel says

A federal task force says that women should start getting regular mammograms to screen for breast cancer at age 40, instead of waiting until 50, marking a shift in the influential panel’s guidelines. 

According to an announcement made Tuesday from the U.S. Preventive Services Task Force, women ages 40 to 74 should get screened every other year. Age 40 is also when mammograms should start for transgender men and nonbinary people at average risk.

The advice does not apply to women who've had breast cancer or those at very high risk of breast cancer because of genetic markers. It also does not apply to women who had high-dose radiation therapy to the chest when they were young, or to women who've had a lesion on previous biopsies.

Previously, the task force long said women could choose to start breast cancer screening as young as 40, with a stronger recommendation that they get the X-ray exams every two years from age 50 through 74.

young woman receiving mammogram with nurse

A lady with the help of a nurse gets a free mammogram (Credit: Eduardo Briones/Europa Press via Getty Images)

The draft recommendation was announced last May and was published in the Journal of the American Medical Association.

"It’s a win that they are now recognizing the benefits of screening women in their 40s," Dr. Therese Bevers of MD Anderson Cancer Center in Houston told The Associated Press. She was not involved in the guidance.

Last year, former task force chair Dr. Carol Mangione said, "This new recommendation will help save lives and prevent more women from dying due to breast cancer." 

Mammogram age

Health organizations have long had different screening recommendations, seeking to balance catching breast cancer early while avoiding too many false alarms, when the X-rays spot non-cancerous blips.

While the task force now recommends all women receive a breast cancer screening starting at age 40 other health groups differ over when and how often to screen, which may lead to confusion.

Medical groups, including the American College of Radiology and the American Cancer Society, suggest mammograms every year — instead of every other year — starting at age 40 or 45. 

While the frequency may continue to vary among experts, Bevers noted, "Now the starting age will align with what many other organizations are saying."

Breast cancer death rates 

Breast cancer death rates have fallen as treatment continues to improve. But breast cancer is still the second-most common cause of cancer death for U.S. women. 

According to the Centers for Disease Control and Prevention, about 240,000 cases are diagnosed annually and nearly 43,000 women die from breast cancer

Overall, the average risk of a woman in the United States developing breast cancer sometime in her life is about 13%. This means there is a 1 in 8 chance she will develop breast cancer. This also means there is a 7 in 8 chance she will never have the disease, explained. 

The task force noted that Black women are 40% more likely to die of breast cancer than White women, making mammograms at 40 an especially important step -– but also urged more research to better understand and combat the disparity.

The task force also noted that nearly half of all women have dense breasts, which means mammograms may not work as well and called for more research into whether additional types of testing would help.

What is a mammogram?

A mammogram is an X-ray picture of the breast. Doctors use a mammogram to look for early signs of breast cancer. Regular mammograms can find breast cancer early – sometimes up to three years before it can be felt.

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For the screening, the person will stand in front of a special X-ray machine. A technologist will place their breast on a plastic plate. Another plate will firmly press your breast from above. The plates will flatten the breast, holding it still while the X-ray is being taken. Some pressure will be felt. The steps are repeated to make a side view of the breast. The other breast will be X-rayed in the same way. Next, they will wait while the technologist checks the X-rays to make sure the pictures do not need to be redone.

Mammogram cost

Congress already passed legislation requiring insurers to pay for mammograms for women 40 and older without copays or deductibles. 

In addition, the Affordable Care Act requires insurers to cover task force recommendations with an "A" or "B" letter grade. The mammography recommendation has a "B" grade, meaning it has moderate net benefit.

For people who are uninsured, but haven’t received a low-cost or free mammogram, mammogram costs can vary widely.

However, there are many programs and services available to help women, including uninsured and underinsured women, access breast cancer screenings.

This story was reported from Los Angeles. The Associated Press contributed.