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Breast Imaging Guidelines

As the region’s leading academic health system, Erlanger reviews the latest medical research to help you decide if you need breast cancer screening. Below are answers to some of the most frequently-asked questions. For more information or to schedule your screening, call 423-778-PINK (7465).

At what age should I start getting mammograms?

We recommend that all women should have an annual mammogram starting at age 40.

While early screening can be controversial, and patients need to be aware of the risk of "false positives," the medical literature shows that screening can have life-saving benefits for women age 40–49. 

How often should I get a mammogram?

We recommend a yearly mammogram between the ages of 40–54 years old. If there is an abnormal finding on your mammogram, your radiologist may ask you to have your next one in six months instead of waiting a year.

What if I am over 55 years old?

We recommend that you continue annual mammograms past age 55. However, if prior mammograms have been normal, and you don’t have an elevated risk for breast cancer, then you may consider getting a mammogram every two years.

When can I stop getting mammograms?

We recommend that you continue getting mammograms while you are in good health. You may consider discontinuing screenings past age 75.

Should I worry about receiving radiation from a mammogram?

No. You receive more radiation on a long airplane flight than you do from a mammogram.

Breast cancer runs in my family, what do you recommend?

In a small percentage of families, breast cancer is hereditary, meaning that it is due to inherited changes in certain genes such as the BRCA1 and BRCA2 genes. People in these families who inherit the genetic change have a higher chance to develop breast cancer and possibly other types of cancer and may require earlier and more frequent screening. Some of the features often seen in families with hereditary cancer include:

  • Cancer occurring at younger ages than usual (usually under age 50)
  • Several relatives with the same or related cancers
  • More than one type of cancer in the same individual
  • Individuals with rare cancers, such as male breast cancer

If your family history has features of hereditary cancer or you are concerned about your family history of cancer, you may benefit from a genetic evaluation. Erlanger’s Medical Genetics team can help determine if genetic testing is right for you. For more information, please visit our genetics page here

Are mammograms necessary before age 40?

Women under age 40 with an average risk of breast cancer generally don’t need mammography screening. If you are concerned, we recommend that you review your family history and concerns with your primary physician. Your doctor can refer you to a breast cancer specialist if needed.

My doctor says I have dense breasts? What type of screening do I need?

There are no national guidelines on imaging for dense breasts. At Erlanger, we recommend starting with standard screening mammography. We also offer 3D tomosynthesis which has been proven to improve the effectiveness of mammography in dense breasts. Other technologies for enhanced breast screening are currently being evaluated and may become available in the near future.

What about breast scintigraphy, thermography, and ductal lavage instead of a mammogram?

There is no quality medical literature to support these methods of breast cancer screening.