New Mammogaphy Guidelines

Mammography now recommended starting at age 40

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Mammography guidelines have changed over the past several years regarding when to start and how often to  have the screenings. Now there's been yet another change in mammography guidelines.

The American College of Obstetricians and Gynecologists has published new mammography guidelines for women. The organization recommends screenings not every other year, but every year when a woman turns 40.

Ask your doctor about the mammography schedule that's right for you.

The College's new recommendations are based on three things, according to Jennifer Griffin, M.D., MPH, who co-authored The College guidelines:

  1. The incidence of breast cancer - an estimated 232,620 people will be diagnosed this year according to the American Cancer Society (ACS)
  2. The "sojourn time" - the amount of time breast cancer grows
  3. The number of deaths - ACS estimates nearly 40,000 will die from

The sojourn time covers the period between when the cancer is first detected by mammography and when it grows large enough to be felt or causes symptoms. Age usually determines the sojourn time. Women in their 40's have the shortest sojourn time - 2-2.4 years, and women 70-74 have the longest - 4-4.1 years.

So while women in their 40's have lower overall incidence of this cancer, the time to diagnose earliest stage tumors is shorter, Dr. Griffin explains. It follows then that annual mammograms will more likely catch cancers at their most treatable stages when survival rates are also highest. There's a 98 percent five-year survival rate for breast cancers that are discovered early, when they're small and located only in the breast.

Here's a summary of the latest College recommendations:

For women 20-39 

  • Clinical breast exams (CBE) by a physician every one to three years
  • Begin "breast self-awareness" noticing any changes in the breast, a practice that should be maintained for life
  • If there's a family history of breast cancer, more rigorous screening may be recommended, including breast MRI (magnetic resonance imaging)

For women 40 and older

  • Annual CDE performed by a physician
  • Continue breast self-awareness
  • Begin annual mammograms
  • These recommendations will change if there's a history of breast cancer

For women 70 and older

  • Speak with your physician about the screening schedule that's best for you

The number of breast cancer cases declined 2 percent every year between 1999 and 2006. Deaths from the disease have also been dropping over the past 20 years.

These new guidelines are detailed in Practice Bulletin #122 "Breast Cancer Screening" and published in the August 2011 issue of Obstetrics & Gynecology.

Reviewed by: 
Review Date: 
July 27, 2011
Last Updated:
July 29, 2011