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Breast cancer screening usually isn’t needed until age 40. However, some people may need screening earlier.
If you have breast cancer risk factors or symptoms, your doctor may recommend screening sooner. If you’re 20 years old and thinking about a mammogram, there are some factors to consider.
This article explains why mammograms usually start at age 40 and which risk factors or symptoms may lead to earlier testing.
Can You Get a Mammogram at Age 20?Mammograms before age 40 are generally not recommended for people who aren’t at increased risk of breast cancer. If you do have a higher risk, the American Cancer Society recommends yearly mammograms and breast magnetic resonance imaging (MRI), usually starting around age 30.
Although early screenings for breast cancer can be beneficial for some people, there are specific reasons medical experts don’t recommend early mammograms for people without risk factors or symptoms.
Although breast cancer can develop at any age, it’s more likely to be diagnosed after 40. In the United States, about 4 percent of women diagnosed with breast cancer are under 40, according to Susan G. Komen.
Having mammograms too often or starting them too early can increase the risk of a false positive. A false positive happens when a mammogram finds something abnormal, but additional testing shows it isn’t cancer.
False-positive results can lead to extra testing and follow-up that may be stressful, costly, and unnecessary.
According to the journal Breast Cancer Research and Treatment, younger women often have denser breast tissue. This can make breast cancer harder to detect on a mammogram.
Screening mammography is not recommended for people younger than 40 who are not at increased risk of breast cancer because it has lower sensitivity and higher false-positive rates.
Insurance coverage for mammograms depends on your plan and personal risk factors. Many plans cover screening mammograms starting at age 40, but coverage may differ for younger people unless they have symptoms or a higher risk of breast cancer.
You can call your insurance company to ask about the details of your plan and what coverage to expect.
Most people at average risk start routine breast cancer screening at age 40, but people at higher risk may need to start earlier.
People at high risk are often advised to get a breast MRI and a mammogram every year, usually starting around age 30. Because breast cancer risk varies from person to person, talk with your healthcare provider about when you should begin screening.
What raises the risk of breast cancer? Here are some factors that may lead to early screening.
A family history of breast cancer is an important factor in understanding your breast cancer risk. People with a family history of breast cancer have a higher risk of developing the disease.
Mutations (changes) in certain genes significantly raise the risk of breast cancer. These genetic mutations can run in families.
If you or a close relative tests positive for a gene mutation linked to breast cancer, your risk may be higher. These mutations can occur in the following genes:
Breast cancer is also linked to several inherited conditions, including:
If you have a family history of breast cancer, one of these gene mutations, or one of these genetic conditions, you may benefit from earlier screening.
Radiation exposure to the chest can increase the risk of breast cancer. If you received radiation therapy to the chest in the past, such as during treatment for childhood cancer, you may need to start breast cancer screening before age 40.
Even without other risk factors, you may need breast imaging if you notice symptoms such as:
Tell your doctor if you notice any unusual changes in your breasts.
It’s normal to feel a little nervous before a mammogram. Don’t hesitate to ask your healthcare provider questions about the procedure so you know what to expect.
A mammogram uses low-dose X-rays to create images of breast tissue. It can help find abnormal changes that may need further testing.
There are two main types of mammograms — two-dimensional (2D) and three-dimensional (3D). A 2D mammogram takes breast images from two angles, usually top to bottom and side to side. A newer type, a 3D mammogram (also called breast tomosynthesis), takes multiple images but isn’t available at every imaging center.
Avoid wearing deodorant, lotion, or other products to your mammogram appointment because they can affect the X-ray images. Otherwise, you can follow your usual routine. You don’t have to change your diet or medications before the test.
The mammogram itself usually takes 15 to 20 minutes. During the test, your breast is placed between two plates that gently compress the tissue.
X-rays pass through the breast and create digital images. One breast is imaged at a time.
A radiologist (a doctor who specializes in interpreting medical images) reviews the images. They then send a report to your healthcare provider, who will discuss the results with you.
If it would help ease your anxiety, consider bringing a trusted friend or family member to your appointment. Because mammograms put pressure on the breasts, you may prefer to avoid scheduling the test during the week before your period, when your breasts may be more tender.
A mammogram can be an important tool for finding breast cancer early. However, the results alone can’t diagnose breast cancer. They help determine whether you need more testing.
Additional imaging tests can provide a closer look at breast tissue. Your doctor may recommend an MRI or a breast ultrasound after a mammogram.
A breast biopsy can help diagnose breast cancer. During this procedure, a small sample of abnormal tissue or fluid is removed with a needle and examined under a microscope. Because just a small sample is taken, the procedure is done with local anesthesia, and you can go home the same day.
Fortunately, most abnormal mammogram results aren’t caused by breast cancer. Other possible causes include:
These other conditions are not cancer, but some may require treatment or monitoring.
It’s important to talk with your doctor if you have concerns about your breast health or breast cancer risk. Early breast cancer screening is not necessary for everyone, but in some cases, it may be the right choice.
On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.
At what age did you have your first mammogram? Let others know in the comments below.
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