Actually, Mammograms Should Start When You Turn 40

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As breast cancer rates rise in young women, an expert health panel recommends starting routine mammograms earlier, at 40 years old. The recommendation, which was finalized by the U.S. Preventive Services Task Force on Tuesday, walks back previous guidelines that advised women to wait until 50.

The task force first published a draft recommendation of the new guidelines in the Journal of the American Medical Association last year, citing an increase in the number of cancer diagnoses in women under 50 and high breast-cancer mortality rates in Black women, who are 40 percent more likely to die of the disease than white women of the same age. The finalized recommendation reverses the task force’s 2009 decision to raise the age for routine mammograms from 40 to 50; at the time, researchers worried earlier screenings would lead to unnecessary and invasive treatments, according to the New York Times. The task force previously suggested that women who wanted to start screenings earlier, between the ages of 40 and 50, should decide whether to do so on an individual basis, depending on personal preferences and risk factors.

While the breast-cancer mortality rate for U.S. women has dropped by over 50 percent in recent decades, the disease remains the second leading cause of cancer death among American women. Between 2015 and 2019, breast-cancer rates among 40-somethings increased by roughly 2 percent each year, and the reason for the spike isn’t entirely clear: “We don’t really know why there has been an increase,” Dr. Carol Mangione, a former chair of the U.S. Preventive Services Task Force, told the Times in 2023. (Some experts have theorized that the uptick may be due to the fact that women are delaying childbirth or not at all, noting that having children before the age of 35 and breastfeeding reduces your risk.)

Some medical experts, however, don’t think these revised recommendations go far enough. For instance, the American College of Radiology advises getting mammograms every year rather than once every other year. It also recommends additional scans for women with dense breast tissue — nearly half of American women have dense breasts — who are at a higher risk for breast cancer and whose cancers can be hard to detect on standard mammograms. Even so, the task force has declined to recommend additional scans for women with dense breasts, making it more difficult for women to get supplementary screenings covered by insurance.