When should you get your first mammogram?


In this article:

  • Breast cancer rates among young women have been increasing for the last 20 years.

  • New breast cancer screening guidelines recommend mammograms starting at age 40.

  • Women should speak to their doctors about their breast cancer risk to find out when they should receive their first mammogram.

When should you get your first mammogram?

The rate of breast cancer in women under age 50 has been increasing every year. Alarmingly, these cancers aren’t necessarily in early stages; some are discovered later or are invasive and have spread to other areas of the body.

“In the past two decades, we have seen a significant rise in the incidence of breast cancer in young women,” says Michaela Tsai, M.D., medical director of breast medical oncology. “There are likely many reasons for this increase, although research to truly define the causes is ongoing.”

In response to these earlier cancer diagnoses, experts have reevaluated screening guidelines and advice for women. You may need a screening mammogram earlier than you think.

Why breast cancer rates are increasing in younger women

It’s not always clear why younger women are getting breast cancer in higher rates. There are some theories, including:

  • Waiting longer to start a family (pregnancy and breastfeeding can lower your risk for breast cancer).
  • Taking hormonal contraception for longer periods of time and at a younger age.
  • Starting their period at a younger age.
  • Higher rates of obesity in younger women.
  • Drinking more alcohol.

Some combination of these factors may be increasing breast cancer rates, but more research is needed to determine root causes and what prevention techniques may work to lower breast cancer rates in younger women.

What the new breast cancer screening guidelines say

In May 2023, the United States Preventive Services Task Force (USPSTF) released new breast cancer screening guidelines. The biggest change was to the age at which women should start getting mammograms. In the past, the USPSTF recommended mammograms every other year starting at age 50. Now they recommend them at age 40 for all women.

The American Cancer Society (ACS) guidelines are a little different. While the USPSTF recommends screenings every other year, the ACS recommends mammograms every year starting at age 45. Your doctor can help you decide which guidelines to follow.

“Some women with a strong family history or a known genetic predisposition to breast cancer may need to start screening at an even younger age,” says Dr. Tsai. “It is best for each woman to have a conversation with their doctor to determine what age is most appropriate for them.”

Genetic testing options for breast cancer

Another way to understand your risk for breast cancer at a young age is through genetic testing. If you have a strong family history of breast cancer, especially if these cancers were associated with BRCA1 or BRCA2 genes, you should consider genetic testing. A strong family history of breast cancer may mean:

  • Having a mother, sister or daughter diagnosed with breast cancer under age 40.
  • Having a male family member with breast cancer.
  • Having three or more family members with breast cancer.

If you aren’t sure if genetic testing is right for you, speak with your doctor. They can help you take a risk assessment and refer you to a genetic counselor who can help.

Hope for patients with breast cancer at any age

New, effective treatments have been developed for breast cancer that can help women at any age and at any stage of cancer. These treatments tend to be more targeted, so they have fewer side effects on the rest of the body.

“In recent years, there have been a number of new treatments developed and made available for women with breast cancer,” says Dr. Tsai. “Treatment has become more targeted and less toxic. There are many more treatments being investigated.”

When detected early, breast cancer can be cured most of the time. As part of National Breast Cancer Awareness Month, Swedish experts encourage you to talk to your doctor about your risk for breast cancer. A mammogram at the right age could save your life.

Learn more and find a provider

Learn more about our advanced cancer services and find a breast cancer expert near you.

Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a physician, caregiver or advanced care practitioner, you can use our provider directory.

Related resources

A recent study found rising cancer rates among younger adults. What to know.

For Breast Cancer Awareness Month, breast health tips from a Swedish expert

Breast cancer: New research. New therapies. New hope.

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.