October 9, 2023

Did you know that mammograms have helped reduce breast cancer deaths in the U.S. by nearly 40% since 1990? There are differing guidelines and recommendations on when to begin getting mammograms and how often. Mankato Clinic follows the guidelines of the American College of Radiology.

Hannah Brandts MD

Diagnostic Imaging

The American College of Radiology continues to recommend annual mammograms starting at age 40 for women of average risk for breast cancer and earlier if a patient has an elevated risk for developing breast cancer.

The 3D tomosynthesis (TOMO) mammogram is recommended. While the machine and procedure are the same as a 2D mammogram, the 3D mammograms offer a more detailed view of the breast tissue, resulting in fewer callbacks for additional imaging and providing earlier detection of Breast Cancer.

Screening mammograms starting at age 40 is important because one in six breast cancers occurs in women in their 40s.

Annual mammograms also allow radiologists to compare your breast tissue from year to year and look for any changes.

What is your risk?

Evaluating your risk for breast cancer begins in appointments with your primary care provider or gynecologist. Beginning at age 30, we attempt to gather information on your personal and family history. For women under 40, this is often done at your annual appointment with your provider. Women 40 and over, this information is gathered at your annual screening mammogram appointment.

Breast Health looks at personal and family history and enters this information into our risk model, called the Tyrer-Cuzick model, to calculate a risk score. If your score is greater than 20%, the Mankato Clinic and the American College of Radiology recommend an annual screening breast magnetic resonance imaging (MRI) beginning at age 25 alternating with annual screening mammograms starting at age 30. After turning 30, alternating the two screenings in 6-month intervals is recommended for women at high risk.

Your risk score is re-evaluated at every mammogram appointment. Women may see their score fluctuate with aging or changes in personal and family history.

Risk factors include a parent, grandparent, sister, or child with breast or ovarian cancer, personal history of breast cancer, breast biopsies that indicate a high-risk lesion, or a gene mutation based on genetic testing. Other risk factors include Ashkenazi Jewish ancestry, Black American ancestry, dense breast tissue type, obesity, and smoking. The risk model also looks at personal history such as first menses, menopause status, hormone replacement therapies and pregnancies. With all this information the model calculates an individual lifetime risk score for developing breast cancer.

How does dense breast tissue affect mammogram results?

The Mankato Clinic Breast Health Team now has a new method of evaluating breast density when having your screening mammogram. The system uses volumetric density, which is taking the total volume of density in your breasts. The breast density is evaluated by a computer within the mammogram machine to make it more consistent from year to year when you have your screening mammogram. With this change, we are seeing an increase in a patient’s risk score in patients with dense breasts.

Talk with your primary care provider about breast health. To learn more, visit our Breast Health Imaging Center.  

Most health insurance plans cover regular mammograms. Call the number on the back of your insurance card to check your coverage.

Emily Retzlaff, RN, Mankato Clinic Breast Health Manager, contributed to this article.