Radiologist Questions Mammogram

What's the earliest I can get a mammogram?

I'm 25. Both my mother and grandmother had breast cancer (both caught early in their 40s and they are both in remission). When can I start getting checked and how often? Is there such a thing as too early?

12 Answers

There is never such a thing as too early. Typically, it's recommended for women to have their mammograms once they turn forties. However, because you have a family a family history of breast cancer, you should consider getting a mammogram earlier. You should have a mammogram every year.
This is a rather complex question. Due to the fact however that you are only 25, it is probably unlikely that you are at this moment at risk for breast cancer. The caveat is that your mother and grandmother had breast cancer in their 40s and apparently early on. The breast cancers start small of course and usually take almost 7 years to develop into a cancer which can be seen on mammography. There are exceptions to this however.
Younger women tend to have much denser breast tissue than older women. This can make a breast-cancer very difficult to detect in a younger woman using standard mammography. You may wish to go outside of the standard mammogram and pursue 3-D mammography as well. The most difficult breast to evaluate would be one in a lactating female or a woman who was pregnant. You may want to start having mammograms potentially at 30 unless you feel a lump developing in your breasts. You also may want to consider MRI examination of the breasts. This however is extremely sensitive at finding “things“, however, the sensitivity can sometimes lead to unnecessary biopsies. Finally, since both your grandmother and your mother had breast cancer at such a young age, I would strongly urge that you undergo genetic testing. This would give you better information as to your risk. If you have the BRCA1 or the BRCA2 gene, you are at higher risk. I feel this would be especially helpful in your instance.
You should have genetic testing done to determine if you carry the BRCA genes that put you at increased risk for breast cancer. You should also request MRI breast screening based on your family history. This will reduce your risk of exposure to radiation from mammograms. Radiation from mammograms is minimal, but if you are looking to start screening at your young age you should try to avoid radiation exposure as much as possible since it is cumulative over your lifetime and cannot be undone. That being said, sometimes the risk of a mammogram is worth it to reap the benefit of early detection of breast cancer. It’s a balancing act. I’d push for MRI screening, preferably somewhere that has a large center or university medical center dedicated to breast imaging.
If you pay cash, you can get anything you want. Each insurance policy is different and the indication is very important.
The current ACR recommendations for high risk patients is a screening mammography at age 30, but not before age 25. Additionally, screening with Whole Breast Ultrasound and/or MRI can be performed. Check with your doctor and health insurance company to see if these tests are covered in a high risk patient such as yourself ( US is usually easily approved, but MRI is more difficult due to it’s cost ).
This is a rapidly evolving topic and I will admit to you that mammography
and breast cancer are not my areas of expertise. However, I'm fairly
confident that, given your family history, your are almost certainly at
higher risk. With that being said, I believe that you'd be a candidate for
screening MRI. I'd recommend for you to contact your local / regional
breast cancer center and have a consultation.

Wish I were more help.

All the best.
The ACR and SBI recommend mammograms starting at the age 10 years before the age your mother and grandmother were diagnosed with cancer. You can also consider breast MRI or complete breast sonograms. If you have a genetic defect insurances might help pay for the MRI.
Ultrasound first, breast MRI if that is indeterminate, avoid radiation and compression if possible, dlh
It is generally recommended that if you have a first degree relative diagnosed with premenopausal breast cancer you should begin screening 10 years prior to there diagnosis ( for example if they were 45 at the time of diagnosis you would begin screening at 35). You should discuss this with your doctor. You may be high risk and I would recommend this also be discussed with your physician
The recommendation is that you start with yearly mammograms 5 years before the time your relative (relative diagnosed at the youngest age) with breast cancer. You should do monthly self exams and tell you physician if you feel anything of concern. If you go on line and look for the Tyler Cusick breast risk calculator it will give you an idea of your risk. If your lifetime risk is >20% many insurance companies will also cover year MRIs or Ultrasounds
Talk to your doctor about your family history. You may be in a special category that requires earlier screening start date. You may not be too early to start.
Where you live and the type of insurance coverages may factor into any decision as to when you can start having mammograms, however generally speaking with a familial history of breast cancer studies may begin between 30-35 years of age. If you have any genetic testing that indicates you have a gene which increases your risk that may further lower the age at which a mammogram may be ordered. MRI of the breast may also be an alternative to mammograms. As always, learning to do a breast self exam properly and performing it routinely is important and something you can begin doing at any time and can help catch lesions at their earliest stage.