This campaign is designed to help men and women understand their personal risk of breast cancer and screening recommendations.
What is screening?
Screening is looking for signs of disease before a person has symptoms. The goal of screening mammography is to find cancer at an early stage when it can be treated and cured.
Getting a mammogram — A mammogram (“mammography”) is a breast X-ray. It is the best screening test for detecting breast cancer at an early stage.
Before the mammogram, you will be asked to undress from the waist up and wear a hospital gown or cape. Each breast is X-rayed individually. The breast is flattened between two panels. This can be uncomfortable, but it only takes a few seconds. If you still get a monthly period and your breasts are sensitive before or during your period, try to avoid scheduling your mammogram during that time if possible. Also, do not use underarm deodorant or powder on the day of your appointment; if you forget and do apply deodorant, you can request a special wipe to remove deodorant before the mammogram.
Mammogram results — A radiologist will review and interpret your mammogram. After the radiologist reviews your mammogram, you should get a phone call or letter with your results within 30 days. If you do not hear back about your results, call the office or hospital where you had the mammogram, or your doctor or nurse’s office, rather than assuming that your mammogram was normal.
What if my mammogram is abnormal? — If your mammogram is abnormal, you will likely need further testing. In fact, in the United States, about 1 in every 10 people who are screened will have an abnormal mammogram requiring follow-up. Most often when this happens, you will need to have more images taken (either mammogram or ultrasound images). Needing more images is common and does not usually mean that you have cancer. Knowing that this is common may help to reduce your anxiety if this happens to you. The extra images help the radiologist to have the most accurate and clear view of your breast tissue. Occasionally, additional testing such as a breast biopsy (in which a small amount of tissue is removed for examination) is needed to follow up on an abnormal screening mammogram result.
What if my mammogram is normal but I feel a lump? — Some breast cancers cannot be seen on a mammogram. So it is possible to still have breast cancer even if your mammogram comes back “normal.” For this reason, it’s still important to let your health care provider know right away if you notice a lump in your breast or have any other concerns about your breasts.
Ultrasound is not typically used as a routine screening test for breast cancer. But it can be useful for looking at some breast changes, such as lumps (especially those that can be felt but not seen on a mammogram). Ultrasound can be especially helpful in women with dense breast tissue, which can make it hard to see abnormal areas on mammograms. It also can be used to get a better look at a suspicious area that was seen on a mammogram.
A breast ultrasound is also not recommended as a routine screening test for people at average risk for breast cancer. Studies have shown that people who are screened with both mammograms and ultrasound tests are more likely to be referred for unnecessary breast biopsies, and so the benefit of adding ultrasound to mammography is not clear.
MRI uses a strong magnet (rather than X-rays) to create a detailed image. Breast MRI may be recommended, in addition to mammography, to help find breast cancer in people with a very high risk for developing breast cancer (such as those with a very strong family history of breast cancer, or a genetic mutation like BRCA1 or BRCA2).
However, breast MRI is not recommended for routine screening in people who do not have a high risk of breast cancer. Compared with mammograms, breast MRI is associated with more “false-positive” findings (changes that turn out not to be cancer), may lead to more unnecessary biopsies, requires intravenous contrast (dye injected into the veins), and is more expensive.
Information as of March 2022, courtesy of UpToDate
Self Breast Exam.
Self breast examination isn’t recommended as a screening tool for breast cancer and should not replace screening tests such as mammography.
In 2018, the American College of Radiology issued new recommendations that all women be evaluated for breast cancer risk by age 30, so that those at higher risk can be identified and begin screening before age 40 .
The risk assessment model used in this tool is based on the modified GAIL model for absolute risk of breast cancer. Calculators such as this one can overestimate or underestimate your risk. Use the links below to compare your result with similar tools.
The American College of Radiology recommends that women of average risk start getting annual mammograms at age 40 .
By not getting annual mammograms, starting at age 40, you increase your changes of dying from breast cancer and the likelihood that you will experience more extensive treatment for any cancers found.
Annual mammography screening starting at age 40 provides the greatest breast cancer mortality reduction by enabling diagnosis at smaller sizes and earlier stages, better surgical options, and more effective chemotherapy. Delaying screening until age 45 or 50 results in unnecessary loss of life to breast cancer, adversely affecting minority women in particular.
Higher-risk women should start mammographic screening earlier and may benefit from supplemental screening modalities. For women with genetics-based increased risk (and their untested first-degree relatives), with a calculated lifetime risk of 20% or more or a history of chest or mantle radiation therapy at a young age, supplemental screening with contrast-enhanced breast MRI is recommended. 
Breast MRI is also recommended for women with personal histories of breast cancer and dense tissue, or those diagnosed by age 50. Others with histories of breast cancer and those with atypia at biopsy should consider additional surveillance with MRI, especially if other risk factors are present. Ultrasound can be considered for those who qualify for but cannot undergo MRI.
All women, especially black women and those of Ashkenazi Jewish descent, should be evaluated for breast cancer risk no later than age 30, so that those at higher risk can be identified and can benefit from supplemental screening.
The American College of Radiology (ACR) has published breast cancer screening recommendations for transgender and gender nonconforming individuals. Data is limited about breast cancer risk in the LGBTQ+ community and recommendations are guided by sex assigned at birth, use and duration of hormone treatment, and surgical history.
Annual screening at age 40 is usually recommended for transfeminine (male-to-female) patients who have used hormones for ≥5 years, as well as for transmasculine (female-to-male) patients who have not had mastectomy .
In transfeminine individuals at higher-than-average risk, 25 to 30 years of age or older, and with 5 or more years of hormone use, breast cancer screening is usually appropriate.
In average-risk transmasculine (female-to-male) individuals who are 40 years of age or older with breast reduction or no chest surgery, a screening mammogram is appropriate.
In intermediate-risk transmasculine individuals 30 years of age or older with breast reduction or no chest surgery, screening mammogram is appropriate, and breast ultrasound or breast MRI with and without intravenous contrast may be appropriate.
Individuals who identify as lesbian, gay, bisexual, transgender, or queer are less likely to present for cancer screening than non–lesbian, gay, bisexual, transgender, or queer persons . Facilities must work to create a respectful environment that welcomes all people .
The lifetime risk of breast cancer for a man is approximately 1:833, as compared with 1:8 for a woman. Breast cancer is about 100 times less common for men than women. The American Cancer Society estimates about 2,710 new cases of male breast cancer will be diagnosed in the United States in 2022. There are multiple risk factors for development and we want you to be aware of the factors that may increase your risk of male breast cancer.
Breast cancer risk is doubled for men who have a first-degree relative with breast cancer. In men with breast cancer, about 1 out of 5 have a close relative, male or female, with the disease. The highest incidence and death rates of male breast cancer are found in non-Hispanic Black men and men over 80 years old.
Due to low prevalence and limited data to support male breast cancer screening, there are currently no recommendations for image-based screening in asymptomatic men and few recommendations for men at high risk for breast cancer such as those who have high risk genetic mutations .
The National Comprehensive Cancer Network (2.2022) recommends men who have a BRCA pathogenic variant or likely pathogenic variant undergo the following screening:
- Begin breast self-exam training and education starting at age 35 years old.
- Clinical breast exam, every 12 months, starting at age 35 years old.
- Consider annual mammogram screening in men with gynecomastia starting at age 50 or 10 years before the earliest known male breast cancer in the family (whichever comes first) .
We have provided a list of references for the materials discussed in this educational module.
- Breast Cancer Screening in Women at Higher-Than-Average Risk: Recommendations From the ACR
Monticciolo, Debra L. et al. Journal of the American College of Radiology, Volume 15, Issue 3, 408 – 414 https://www.jacr.org/article/S1546-1440(17)31524-7/fulltext
- Lee CS, Sickles EA, Moy L. Risk Stratification for Screening Mammography: Benefits and Harms. AJR Am J Roentgenol. 2019 Feb;212(2):250-258. doi: 10.2214/AJR.18.20345. Epub 2018 Dec 17. PMID: 30557052. https://pubmed.ncbi.nlm.nih.gov/30557052/
- Boughey JC, Hartmann LC, Anderson SS, Degnim AC, Vierkant RA, Reynolds CA, Frost MH, Pankratz VS. Evaluation of the Tyrer-Cuzick (International Breast Cancer Intervention Study) model for breast cancer risk prediction in women with atypical hyperplasia. J Clin Oncol. 2010 Aug 1;28(22):3591-6. doi: 10.1200/JCO.2010.28.0784. Epub 2010 Jul 6. PMID: 20606088; PMCID: PMC2917314. https://pubmed.ncbi.nlm.nih.gov/20606088/
- Breast Cancer Screening Recommendations Inclusive of All Women at Average Risk: Update from the ACR and Society of Breast Imaging. Monticciolo, Debra L. et al. Journal of the American College of Radiology, Volume 18, Issue 9, 1280 – 1288. https://www.jacr.org/article/S1546-1440(21)00383-5/fulltext
- Haviland KS, Swette S, Kelechi T, Mueller M. Barriers and Facilitators to Cancer Screening Among LGBTQ Individuals With Cancer. Oncol Nurs Forum. 2020 Jan 1;47(1):44-55. doi: 10.1188/20.ONF.44-55. PMID: 31845916; PMCID: PMC7573971. https://pubmed.ncbi.nlm.nih.gov/30557052/
- Perry H, Fang AJ, Tsai EM, Slanetz PJ. Imaging Health and Radiology Care of Transgender Patients: A Call to Build Evidence-Based Best Practices. J Am Coll Radiol. 2021 Mar;18(3 Pt B):475-480. doi: 10.1016/j.jacr.2020.10.008. PMID: 33663757. https://pubmed.ncbi.nlm.nih.gov/33663757/
- American College of Radiology ACR Appropriateness Criteria®. Transgender breast cancer screening.
ACR, Reston, Virginia2021
- Woods RW, Salkowski LR, Elezaby M, Burnside ES, Strigel RM, Fowler AM. Image-based screening for men at high risk for breast cancer: Benefits and drawbacks. Clin Imaging. 2020 Mar;60(1):84-89. doi: 10.1016/j.clinimag.2019.11.005. Epub 2019 Nov 28. PMID: 31864206; PMCID: PMC7242122. https://pubmed.ncbi.nlm.nih.gov/31864206/
- National Comprehensive Cancer Network. (2022). BRCA-Pathogenic/Likely Pathogenic Variant – Positive Management (version 2.2022). Retrieved from https://www.nccn.org/professionals/physician_gls/pdf/genetics_bop.pdf
We have created examples of women to help you understand potential risk factors for breast cancer.
Frequently asked questions.
We have answers to the most asked questions.
False-positive results are common with screening mammography, especially in younger women, leading to further imaging and radiation exposures and breast biopsies.
Yes, but your doctor might recommend not scheduling them close together.
Some people have had temporary swelling of lymph nodes in the armpit (“axillary”) area after getting certain COVID-19 vaccines. In some cases, this can make it harder for the radiologist to interpret your mammogram. For this reason, experts recommend trying to schedule your mammogram either before you get the COVID-19 vaccine, or at least four to six weeks after your last dose.
If you’re not sure when to schedule your mammogram, talk to your health care provider. They can help you make this decision based on your situation. While breast cancer screening is important, it is also very important to get the COVID-19 vaccine when you are able.
Certain ethnic groups are at higher risk of developing breast cancer. For example, African-American women are 42% more likely to die from breast cancer than non-hispanic white women despite roughly equal incidence rates.
Screening should continue through at least age 74, and beyond that based on overall health. Mammogram screening is recommended for all women with ≥ 10 year life expectancy.
Almost 50% of women 40 to 74 years of age have dense breasts, which is a risk factor for breast cancer and for false negative results on standard mammography. Ultrasound, MRI, and 3D mammography have been proposed as methods to detect breast cancer that might be missed on mammography.
The American College of Radiology recommends that women with a 20% or higher lifetime risk of breast cancer be offered annual mammography and magnetic resonance imaging, typically starting at 30 years of age. For high-risk women 25 to 29 years of age, ACOG recommends a clinical breast examination every 6 to 12 months and annual breast MRI with contrast.
Women with close relatives who’ve been diagnosed with breast cancer have a higher risk of developing breast cancer. If you’ve had one first-degree female relative (sister, mother, daughter) diagnosed with breast cancer, your risk is doubled. If two first-degree relatives have been diagnosed, your risk is 5 times higher than average.\nIn some cases, a strong family history of breast cancer is linked to an abnormal gene associated with a high risk of breast cancer, such as the BRCA1 or BRCA2 gene.
For those without insurance or difficulty covering the cost of a mammogram, a hospital may have funds or a charity care program where they provide the mammogram for free or at a low cost. Call the hospital near you and ask to speak with a financial counselor who can explain the program and qualification requirements. You can also contact local charities that might pay for the mammogram. Be sure to check first with the organization to see if you qualify and what they will require of you.
We have provided a list of resources below that may assist you if you have difficulty covering the cost of your mammogram.
The BRCA gene test is a blood test that uses DNA analysis to identify harmful changes (mutations) in either one of the two breast cancer susceptibility genes (BRCA1 and BRCA2).
People who inherit mutations in these genes are at an increased risk of developing breast cancer and ovarian cancer compared with the general population.
The BRCA gene test is offered to those who are likely to have an inherited mutation based on personal or family history of breast cancer or ovarian cancer. The BRCA gene test isn’t routinely performed on people at average risk of breast and ovarian cancers.
African-American women have a higher risk of BRCA1 and BRCA2 genetic mutations than women of Western European ancestry. People with BRCA1 or BRCA2 genetic mutations are at much higher risk of breast cancer (55% – 72% for those with a genetic mutation will develop breast cancer by 70 – 80 years of age).
These links are being provided as a convenience and for informational purposes only.
National Breast and Cervical Cancer Detection Program (NBCCDP).
The National Breast and Cervical Cancer Early Detection Program provides breast and cervical cancer screenings and diagnostic services to women who have […]