When Should I Get a Mammogram?

Posted on: October 27, 2015

New guidelines for when women should start getting mammograms have raised questions.

Dr. Bonnie Litvack, Director, Women's Imaging Center, Northern Westchester HospitalDr. Bonnie Litvack, Medical Director of the Women’s Imaging Center at Northern Westchester Hospital, answers questions many women have about when to start getting mammograms in light of the new breast cancer screening guidelines issued by the American Cancer Society, which raised the suggested age that women start getting mammograms at age 45, up from 40 years of age.

The American Cancer Society (ACS) recently issued new guidelines for when women should begin getting mammograms. They previously recommended that women begin getting mammograms at the age of 40, and now they are recommending women begin getting mammograms at age 45. I understand that this can be confusing and frustrating for women, and I want to share information that I hope is both helpful and reassuring.

First and foremost, these new guidelines are meant for women with an average risk of getting breast cancer – women with no family history of breast cancer. These recommendations are not for women who have a family history of breast cancer or who carry the BRCA gene. And if there is any take-away from this message, every woman is different and every woman should speak with her doctor to determine the best plan and timing for beginning or continuing to get mammograms.

I recommend that women begin getting mammograms at the age of 40 and continue to get them annually as long as they are in good health. Why? Because research and science have shown that the maximum amount of lives are saved when we start screening annually at the age of 40, again for women with an average risk of getting breast cancer.

The ACS reasoned that certain “risks” are presented in younger women who get mammograms, such as false positives that lead to additional screenings, or in rare cases, a biopsy. However, I want to be clear, that the benefits of getting a mammogram are objective – it is proven to save lives. The risks are completely subjective. Some women might feel anxious getting a mammogram, or hearing that they need to get additional screening. We work tirelessly to reduce anxiety associated with getting a mammogram. But ask many women, and they would rather have a false positive only to hear that everything is fine after additional screening. We’re balancing anxiety with saving lives, and mammograms save lives.

About those false positives…

At Northern Westchester Hospital, all of our technology is digital. We do not use film mammography, which is what was used in the studies that the ACS based their latest recommendations on. Radiologists have made significant improvements in mammography using digital technology, and we have been using tomosynthesis radiation (3D mammography) which provides quick, clear, and more definitive results. Scientific studies have shown that 3D mammography has reduced false positives by up to 1/3, meaning many fewer of our patients are called back for additional screening.

Finally, the ACS also recommended that all women can skip the clinical breast exam, which is conducted manually by your doctor. I disagree. For our patients, we want to find anything unusual as early as possible. This exam is part of our patients’ regular annual exams, and it does not cost anything. I recommend that women continue to get regular clinical breast exams.

Editor’s Note:
Under the leadership of Dr. Bonnie Litvack, the Women’s Imaging Center at Northern Westchester Hospital has been acclaimed as a Breast Imaging Center of Excellence by the American College of Radiology. She is fellowship trained in MRI and has extensive experience in all aspects of women’s imaging, including mammography.

Read more about Northern Westchester Hospital’s 3-D mammography.