NOTE
The conflicting recommendations for age to start mammography are the result of differing views
of “harm versus benefit“ studies.Mammography may be a screening test for breast cancer when performed on
asymptomatic women. Screening typically uses 2 views of each breast:
craniocaudal and lateral. The patient is encouraged to lean in toward the
device to image as much of the breast tissue as possible.
Recommended age to start mammograms varies among medical
organizations, ranging from age 40−50.
Start screening at age 40 gives potentially earlier cancer diagnosis
(benefit) but at the cost of higher false-positives with unnecessary follow-
up testing and anxiety (harms). False-negatives occur more in younger
women and those with denser breasts.
Start screening at age 50 gives fewer false-negatives (benefit) but at a
cost of potentially later diagnosis (harm).
The best strategy is for doctors to assess individual patient risk and
engage in shared decision-making with the patient.
Mammography may also be performed because of a breast complaint (e.g.,
breast mass, nipple discharge, abnormal screening mammogram); in those
cases many images are taken, some under higher magnification to better
visualize the target area.
Risks: ionizing radiation exposure 0.7 mSv (about the same that the average
person receives from background radiation in three months [1 Rad = 10
mSv])