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You’ve probably already been going for your annual OB/GYN appointment for years now, and are used to getting your pap smear and even a breast exam in your gyno’s office. But as time goes on, it’s important to also see a radiologist to get a more detailed look at your breast health.
One way to take preventative breast healthcare into your own hands is to schedule mammograms as soon as you’re eligible. What’s the right age to get your first mammogram? And if you’re worried about family history, a specific gene, or another factor that could raise your risk, should you plan to go for mammograms earlier?
We’re here with all the information you need to make the process less daunting.
At what age should you get your first mammogram?
It can feel a little bit confusing because guidelines laid out by the U.S. Preventive Services Task Force Guidelines for breast cancer screening have changed: They originally recommended mammograms starting at age 40, raised the age to 50, and as of 2023 are currently recommending getting your first mammogram at age 40 and continuing to be screened every other year. “The data has long shown that annual mammograms beginning at 40 for those of average risk reduces mortality by 40% and saves the most lives,” explains Anjali Malik, MD, a board-certified, fellowship-trained breast imaging radiologist at Washington Radiology in Washington, D.C. The flip-flopping of advice from the U.S. Preventive Services Task Force and the American Cancer Society was based on outdated research and technology, and both groups have since corrected their guidelines, she says.
However, there might be a different suggestion for your screening if you’re at high risk for breast cancer.
Who might be at a higher risk for breast cancer?
First and foremost, certain groups are at an increased risk for breast cancer; for example, if you’re a woman or assigned female at birth, your risk is higher than men. Black women have a higher rate of more aggressive cancer than white women, and are twice as likely to die from breast cancer, according to the American Cancer Society. Specific guidelines have not changed yet for Black women, besides making sure to get screened by age 40.
Genes are another variable: About 5 to 10% of breast cancer is genetic. You might have stronger genes for developing breast cancer if you have sisters, a mother, or a daughter who has had breast cancer. If you have a known genetic mutation, such as the BRCA1 or BRCA2 genetic mutation that might prevent tumor-suppressing genes from working properly, you should see your doctor before age 30 for a risk assessment to come up with a regular screening plan, Dr. Malik says. Unsure if you have the mutation? That’s okay too. Your doctor can do a risk assessment test and evaluate the need for genetic testing. If you have certain genetic mutations or a family history of premenopausal breast cancer (below the age of 35), you might qualify for screening as young as 25, she explains. So it’s best to reach your OB/GYN or primary care doctor when you’re as young as possible to make sure you’re taking as much precaution as possible with your preventative care.
What to expect at your first mammogram
When you’re scheduling your mammogram, try to double-check your calendar or period tracker, to avoid getting screened the week before your period (your breasts might be tender), according to the American Cancer Society. You’ll have to remove everything you’re wearing on top for the mammogram, including your bra. And remember beforehand that it’s not a good idea to wear deodorant, lotion, or perfume to the appointment, which can affect the X-ray and might show up as white spots.
Your provider might ask you some questions, including inquiring about your family or personal history; they may also ask if you’re pregnant or breastfeeding. During the exam, your breasts need to be compressed to get the highest quality images–this can create some pressure and discomfort, per the American Cancer Society. However, it takes only about 10 or 15 seconds to image each breast, and the overall appointment won’t last long.
Is there anything else you can do for good breast health?
Much is not in your control, such as your genes or your innate risk. But knowledge is power: “Know your normal, know your family history, and know how to reduce your risk,” says Dr. Malik. Some ways to reduce your risk of breast cancer include cutting back on your alcohol consumption. Keeping up with regular exercise, and a high-fiber diet that is low in processed meats (the chemicals in grilled, barbecued, and smoked meats can increase cancer risk) can also cut your risk.
Regular mammograms allow you to get ahead of your breast health, but so do keeping up with regular self-exams of your breast tissue —then, as soon as you notice anything that’s not normal, you can spring into action.
Mara Santilli is a journalist reporting on health and wellness and how social and political systems influence the well-being of certain groups, including but not limited to Black and brown communities, women, and the LGBTQ+ community. Her editorial work has appeared in publications such as Shape, Marie Claire, Cosmopolitan, Women’s Health, InStyle, Glamour, and more. Outside of reading and writing, she enjoys traveling (especially to Italy), singing, dancing, musical theatre, and playing guitar and piano.
