When You Might Need a Mammogram Before 40

The American College of Radiology advises that women who have an average risk of developing breast cancer begin screening mammograms at age 40. However, women who have a greater-than-average risk can benefit from starting screenings at an earlier age. How do you know if you fall into a high-risk group? Here’s what women under 40 need to know.


When to have a risk assessment

Meghan Musser, DO, radiologist and medical director of the Kettering Breast Evaluation Center, advises that all women undergo a cancer risk assessment before age 30. “The assessment is a computer-based evaluation that looks at a woman’s personal and family history to determine her lifetime risk of developing breast cancer,” Dr. Musser explains. Based on the results of this test, a woman can work with her health care provider to create a screening plan specifically tailored to her risk profile.

What are the risk factors?

Perhaps one of the most well-known risk factors for breast cancer is the BRCA gene mutation. About one in 400[1]women have a BRCA mutation. Depending on what a woman’s risk assessment shows, a doctor may recommend undergoing genetic testing to check for the BRCA or other mutations. “Genetic testing provides information regarding many known mutations that can lead to an increased risk of developing breast cancer, not only BRCA mutations,” Dr. Musser notes.

Other factors that can increase a woman’s risk of breast cancer include

  • Strong family history of breast cancer
  • Personal history of breast cancer
  • Being of Ashkenazi Jewish descent
  • Undergoing chest radiation at a young age
  • History of prior biopsy showing atypical cells
  • Increased breast density

Understanding breast density

Breast density is a measurement of the amount of fat versus glandular tissue in a woman’s breast. In other words, women with dense breasts have a higher proportion of supportive tissue, milk ducts, and glands, than of fatty tissue. Women who are at a lower body weight, are younger, or have taken hormone therapy may be more likely to have dense breasts.

“Women in the highest breast density category have a four times higher risk of developing breast cancer than those in the lowest breast density category,” Dr. Musser explains. “Having a lot of dense breast tissue can also make finding breast cancer more difficult, as both cancers and glandular tissue will show up white on a mammogram.” If you have dense breasts, speak with your health care provider about your risk profile and what screening options will be most effective for you. 3D mammography, which captures multiple images of the breast to form a 3D image, can be more beneficial for women with dense breasts. All breast evaluation centers at Kettering Health Network use 3D mammogram technology.

Factors you can control

While genetics, family history, and breast density are uncontrollable risk factors, there are steps women can take to lower breast cancer risk. For example, some lifestyle choices may also influence risk:

  • Exercise: Regular physical activity reduces the risk of breast cancer. Exercising consistently can also help women stay within a healthy weight range. Especially after menopause, being overweight can increase risk.
  • Alcohol intake: Watching your alcohol consumption can help lower your breast cancer risk. “Women who have one alcoholic drink daily have a small increase in risk compared to non-drinkers, while women who have two to three drinks per day have an increased risk of about 20%,” explains Dr. Musser.
  • Pregnancy and breastfeeding: Having children before the age of 30 lowers a woman’s risk of developing breast cancer. Additionally, breastfeeding can reduce risk, especially if women breastfeed for a year or more.

The most important step in the early detection of breast cancer is to speak with a health care provider about your risk factors. To find a primary care provider, visit ketteringhealth.org/findaphysician/

[1] National Breast Cancer Foundation, Inc., https://www.nationalbreastcancer.org/what-is-brca

Leave a Reply

Your email address will not be published. Required fields are marked *