Breast cancer is something that touches far too many lives. It is still the most common cancer among women in the United States. About one in eight will face a breast cancer diagnosis in their lifetime.

The encouraging news is that screening mammograms help save lives. They can detect breast cancer early, when treatment is most effective.

Since mammography became widely available in the 1990s, breast cancer deaths have dropped by more than 40%. This progress is due to better imaging technology, more access to screening tests, advancements in treatments and greater overall awareness.

Screening Guidelines and Recommendations

Screening guidelines evolve as technology advances and new data emerges. Different organizations may make slightly different recommendations to balance the benefits of early detection with risks of false positives and additional testing.  

For people at average risk, many leading medical organizations — including the American College of Radiology, Society of Breast Imaging and National Comprehensive Cancer Network (NCCN) — recommend yearly mammograms starting at age 40.

The American Cancer Society notes that annual screening tests offer the greatest benefits for early detection.

When Your Risk Is Higher

People with a higher risk may need to start breast cancer screening earlier or be screened more often. This includes those with:

• A strong family history of breast cancer, including:
• Two or more close relatives diagnosed
• Relatives diagnosed at a younger age (under 50)
• A family history of related cancers like ovarian, pancreatic or prostate cancer
• A known genetic mutation like BRCA1 or BRCA2
• A history of chest radiation
• Certain results from prior breast biopsies

Under these conditions, guidelines may look like:

• Annual breast magnetic resonance imaging (MRI) starting between age 25 and 35
• Annual mammograms beginning around age 30
  

Genetics play an important role in breast health. If you have a family history of breast cancer, your physician may recommend a risk assessment to develop a screening plan that fits you.

Know Your Family History

About 10% to 15% of women with breast cancer have a mother, sister or daughter who also had the disease. Having close relatives with breast or ovarian cancer increases your risk. That risk rises with each first-degree relative diagnosed before menopause.

If breast cancer runs in your family, talk with your physician about a personalized prevention and screening plan. Screening may begin earlier — often up to 10 years before the age at which a close relative was diagnosed. For example, if your mother was diagnosed at 40, you may be advised to start screening at age 30.

“Knowing your personal and family history is essential,” says Dr. Spear. “Genetics can significantly influence both cancer risk and the type and timing of screening.”

People With Dense Breasts

Nearly half of women age 40 and older have dense breast tissue. Dense breasts can make cancer harder to spot on a standard mammogram. Dense tissue may also increase breast cancer risk.

Because of this, some people with dense breasts may benefit from additional screening.

“We now have more tools than ever to improve detection in women with dense breasts,” says Dr. Spear. “Using multiple imaging methods helps us find cancer earlier and with more confidence.”

Screening After Age 74

After age 74, screening becomes more individualized. Decisions depend on overall health, life expectancy and personal preferences. Talk with your physician about what is right for you.

Breast Cancer Screening Technology

Mammography remains the gold standard for breast cancer screening, but advanced technologies and enhanced imaging options can provide more detail and help find cancer earlier.

These tools may include:

• 3D mammography (digital breast tomosynthesis): Creates detailed images that reduce tissue overlap
• Automated breast ultrasound (3D ABUS): Provides whole-breast imaging and can help find cancers missed on mammograms, especially in dense breasts
• Breast MRI: Highly sensitive imaging used for people at high risk or recently diagnosed with breast cancer

“At Northwestern Medicine, we use a comprehensive screening approach,” says Dr. Spear.  “ABUS and advanced breast MRI techniques can help detect cancers that may not be visible on mammography alone.”

Together, these methods allow screening to be tailored based on breast density, risk factors and medical history.

Clinical breast exams and routine screening remain important parts of breast health.

Managing Your Risk for Breast Cancer

You cannot change some risk factors, such as age or family history. But you can take steps to lower your overall risk, including:

• Maintaining a healthy weight
• Eating a healthy diet
• Avoiding tobacco and alcohol
• Exercising regularly to support overall health and manage your stress

Detection Is in Your Hands: Breast Self-Exam

You know your body best. Regular breast self-exams can help you notice changes early. Check your breasts in the shower, in front of a mirror or while lying down.

Watch for:

• Skin changes on the breast or nipple
• Lumps or swelling in the breast or underarm
• Nipple discharge or color changes
• Changes in breast shape or size

Report any changes to your physician. The best time to do a self-exam or schedule a mammogram is about one week after your period ends, when your breasts are often less tender.

Understanding Abnormal Mammogram Results

An abnormal mammogram does not always mean cancer. Many people need follow-up imaging to gather more information.

A diagnostic mammogram provides detailed views of a specific area. It uses the same technology as a regular mammogram but focuses on areas of concern.

Next steps may include:

• Diagnostic follow-up mammogram
• Breast ultrasound
• MRI
• In some cases, a biopsy

Timely follow‑up is important. Your care team will guide you through each step.

Breast Cancer Screening Saves Lives

Today’s screening tools and guidelines give you more options than ever. Start a conversation with your physician about the screening plan that fits your healthcare needs. You may also choose to talk with a breast health specialist.

“Staying proactive with screening, awareness and timely follow-up is one of the best ways we can improve outcomes and save lives,” says Dr. Spear.