Breast Cancer Screening: What You Need to Know

Let’s talk about something close to our hearts—literally!

Breast cancer affects 1 in 8 women in her lifetime. But when caught early, it's highly treatable—and screening plays a vital role. Knowing when to start, what tests to consider, and how your personal risk shapes those choices can feel overwhelming. The good news? You don’t have to figure it out alone.

Let’s break down what you need to know:

Understand Your Personal Breast Cancer Risk

It is estimated that 1 in 4 adults are not up to date on screening recommendations. Far too many in my opinion. Before deciding when and how to begin breast cancer screening, it's important to get a clear picture of your individual risk. Ask your primary care provider about risk assessment using the tools below. Two commonly used tools in clinical practice include:

• GAIL Model – Estimates your 5-year and lifetime risk of developing breast cancer based on factors like age, family history, and reproductive history. https://bcrisktool.cancer.gov/calculator.html

• Tyrer-Cuzick Model – A more comprehensive tool that also incorporates genetic risk and personal health history. This model is best completed with a health care provider. If your primary care provider is not comfortable, most imaging centers are well versed in utilizing these models.

While these models are helpful, they do have some limitations. Talk to your provider.

Knowledge is power. These models help your care team tailor your screening recommendations—and they give you the confidence to make informed decisions about your health. Be sure to talk with your primary care provider on your personal and family history and whether or not they should use these tools to determine your screening recommendations.

If your risk is elevated, your provider may discuss genetic testing for inherited mutations such as BRCA1, BRCA2, ATM, CHEK2, or PALB2. If a mutation is found, most insurance plans cover additional screening with breast MRI, since you would now be considered high-risk under national guidelines.

Asking about risk assessments or genetic testing isn’t overreacting—it’s proactive, and it could shape a screening plan that fits you.

When Should Breast Cancer Screening Begin?

For women at average risk, most national organizations agree that breast cancer screening should begin no later than age 40—but recommendations about frequency can vary.

• The American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) recommend annual mammograms starting at age 40.

• The U.S. Preventive Services Task Force (USPSTF) also supports starting at 40 but allows for mammograms every 1–2 years, depending on personal risk and preference.

In oncology care, we typically recommend annual mammograms, especially in your 40s and 50s, when breast tissue tends to be denser and cancers may develop more rapidly. Annual screening increases the chances of catching cancer early—when treatment is most effective.

Factors like personal risk, breast density, and past mammogram results all matter.

Bottom line: There’s no one-size-fits-all answer. Work with your provider to build a screening plan that feels right for you.

P.S. If you're finding this helpful, share it with a friend, sister, mom—or your favorite bosom buddy.

Breast cancer screening knowledge is something we all should have- pass it on!

Regular breast screenings aren’t just about you—they’re about the people who walk beside you, too

What About Inherited Risk?

While most breast cancers are sporadic, approximately 15% of breast cancers are linked to inherited genetic mutations, such as:

• BRCA1 and BRCA2

• ATM

• CHEK2

• PALB2

If you have a strong family history or a known mutation, your provider may recommend earlier and more frequent screening, as well as genetic counseling. This may include a personalized plan with mammograms and breast MRIs alternating every 6 months for closer monitoring.

Understanding Breast Density

Breast density refers to the amount of fibroglandular tissue seen on a mammogram and is grouped into four categories:

1. Almost entirely fatty

2. Scattered fibroglandular densities

3. Heterogeneously dense

4. Extremely dense

Having dense breasts (categories 3 or 4) can make it harder for mammograms to detect abnormalities. If this applies to you, your care team may recommend additional imaging like ultrasound or breast MRI for better visualization.

Screening Methods Explained

• Mammography – The gold standard for most women.

• Breast MRI – Often used for high-risk individuals and may alternate with mammograms every 6 months.

• Ultrasound – Sometimes added for women with dense breast tissue or specific findings that need further evaluation.

If You Get a Callback: Don’t Panic

Getting called back after a mammogram can feel unsettling—but it’s very common. About 1 in 10 women are asked to return for additional imaging, and most of the time, it’s not cancer. Radiologists often just need clearer views or more information to confirm a finding is benign.

Tips to Make Screening More Comfortable

A few small changes can help your mammogram experience go more smoothly:

• Schedule your exam during the week after your period to reduce breast tenderness

• Wear a two-piece outfit for easier changing

• Try to go to the same imaging center each year—this allows radiologists to compare your prior images more accurately, which can reduce unnecessary callbacks

Lifestyle Habits That Can Lower Your Risk

While screening is critical, your everyday choices matter too. You can lower your risk of breast cancer by:

✔ Maintaining a healthy weight—especially after menopause

✔ Exercising regularly (aim for 150–300 minutes of moderate activity weekly)

✔ Eating a balanced, plant-forward diet

✔ Limiting alcohol

✔ Avoiding tobacco

These changes support your overall health, not just breast health.

Final Thoughts

Breast cancer screening isn’t just a checklist—it’s a conversation. Your personal risk, family history, and health goals all deserve to be part of the plan. With the right information, and a care team that listens, you can build a screening approach that fits you.

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