Breast Cancer Screening: When Should You Start Getting Mammograms?

You schedule your annual physical. You get your blood pressure checked, talk about medications, maybe have routine lab work done. But when was the last time you talked with your primary care provider about your breast health? 

For women, breast cancer screening is an important part of preventive care. And while you may have heard that mammograms should begin at a certain age, deciding when and how often you should be screened isn't always as simple as marking a birthday on the calendar. 

Your age matters, but so do your personal health history, family history, and individual risk factors. 

Rachel P. Anderson, DO, a primary care physician at Archbold Primary Care in Thomasville, Georgia, encourages women to make breast health part of the conversation with their primary care provider—not just during Breast Cancer Awareness Month, but throughout the year. 

Why Are Mammograms So Important?

A mammogram is an X-ray image of the breast that can help identify breast cancer before a lump can be felt or other symptoms develop. 

Finding breast cancer earlier can make a significant difference. When cancer is detected before it has a chance to spread, patients may have more treatment options and better outcomes. 

"Mammograms are an important screening tool because breast cancer doesn't always cause noticeable symptoms in its early stages," Dr. Anderson said. "Keeping up with recommended screenings gives us an opportunity to look for changes before a patient may realize anything is wrong."

While no screening test can detect every breast cancer, routine mammography remains one of the most important tools available for early detection. 

When Should You Start Getting Mammograms? 

For women at average risk for breast cancer, routine mammography generally begins around age 40. However, screening recommendations can vary by the medical organization issuing the guidelines, and recommendations on whether mammograms should be performed annually or every two years can differ as well. 

That's one reason it's important to discuss screening with your primary care provider rather than relying solely on a general recommendation. 

"Age gives us a starting point, but screening decisions should also take the individual patient into consideration," Dr. Anderson said. "We want to understand her health history, her family history and whether there are factors that could increase her risk."

Women who have a higher risk of developing breast cancer may need to begin screening earlier or may benefit from additional screening tests. 

If you're approaching 40 and haven't discussed mammography with your provider, your next primary care appointment is a good time to start the conversation. 

Know Your Breast Cancer Risk Factors

Anyone can develop breast cancer, including people without a family history of the disease. However, certain factors can increase a person's risk. 

Some breast cancer risk factors cannot be changed, including: 

• Increasing age
• A personal history of breast cancer or certain breast conditions
• A family history of breasts or ovarian cancer
• Certain inherited genetic mutations, including BRCA1 and BRCA2
• Having dense breasts
• Previous radiation therapy to the chest, particularly at a young age

Other factors associated with breast cancer risk may be related to lifestyle, reproductive history, hormone exposure and overall health. 

Having one or more risk factors does not mean you will develop breast cancer. Likewise, having few known risk factors doesn't mean screening isn't important. 

Your primary care provider can help put these factors into context and determine whether your individual risk warrants a different approach to breast cancer screening. 

Does Breast Cancer in Your Family Mean You're High Risk? 

Family history is important—but there is more to it than simply whether your mother had breast cancer. 

Tell your primary care provider if breast or ovarian cancer has occurred on either side of your family, particularly if several relatives have been affected or someone was diagnosed at a younger age. A history of male breast cancer, pancreatic cancer or certain other cancers in the family may also be relevant when evaluating hereditary cancer risk. 

In some cases, your family history may prompt your provider to recommend a more detailed risk assessment, genetic counseling, and testing. 

"Patients sometimes assume that if their mother or sister hasn't had breast cancer, they don't need to worry about family history," Dr. Anderson said. "But we want to look at the bigger picture, including both sides of the family."

What Does It Mean to Have Dense Breasts?

You may have received a mammogram report saying you have "dense breasts" and wondered what that actually means. 

Breasts are made up of fatty, glandular and fibrous tissue. Women with dense breasts have a higher proportion of fibrous and glandular tissue compared with fatty tissue.

Breast density matters for two reasons: dense tissue can make some cancers more difficult to see on a mammogram, and breast density itself is associated with an increased risk of breast cancer. 

You cannot determine whether you have dense breasts by how they look or feel. Breast density is determined through mammography. 

If you've been told you have dense breasts, talk with your healthcare provider about what that means for you and whether your individual risk factors indicate a need for additional screening. 

Don't Wait for Your Next Mammogram If You Notice a Breast Change

Screening mammograms are intended for people without symptoms. If you notice a new or unusual breast change, don't have until your next routine mammogram to mention it. 

Contact your healthcare provider if you notice symptoms such as: 

• A new lump or thickening in the breast or underarm
• A change in the size, shape, or appearance of a breast
• Dimpling, puckering or other changes in breast skin
• New nipple changes, including inversion
• Nipple discharge, particularly if it is bloody or occurs without squeezing
• Persistent breast or nipple pain
• Redness, scaling or swelling that doesn't go away

Many breast changes are caused by conditions other than cancer. Still, a new or unexplained change deserves medical attention. 

"Knowing what is normal for your own breasts can help you recognize when something has changed," Dr. Anderson dais. "If something feels or looks different, let your healthcare provider know. You don't have to wait for your annual appointment."

Your Annual Primary Care Visit Is a Good Time to Talk About Breast Health

Primary care isn't only for when you're sick. Preventive visits give you and your provider an opportunity to look at your health as a whole and identify screenings that may be appropriate based on your age and risk factors. 

Breast cancer screening can be part of that conversation. 

Before your next appointment, take a few minutes to think about your family's cancer history. If possible, find out which relatives were diagnosed, what type of cancer they had and approximately how old they were at diagnosis. That information can help your provider better evaluate your risk.

You can also ask questions such as: 

• When should I begin having mammograms?
• How often should I be screened?
• Am I at average or increased risk for breast cancer? 
• Does my family history change my screening recommendations? 
• Do I have dense breasts? 
• Should I consider genetic counseling or testing? 
• Are there other screenings I should consider? 

Make Breast Health Part of Your Preventive Care

October is Breast Cancer Awareness Month, an important reminder to schedule overdue screenings. However, breast health deserves attention all year long. 

If you aren't sure whether you're due for a mammogram—or whether your personal or family history affects your breast cancer risk—start by talking with your primary care provider. 

At Archbold Primary Care, we help patients throughout South Georgia stay proactive about their health through routine preventive care, recommended health screenings, and personalized guidance based on individual health needs. 

Schedule an appointment today with Rachel P. Anderson, DO, or an Archbold primary care provider to talk about your breast cancer risk and the screenings that may be right for you. 

To schedule an appointment at Archbold Primary Care, call 229-584-4100.