Breast cancer screening updates: What you need to know
Regular screenings are a key part of early detection and treatment.
Maybe you’re just starting to think about breast cancer screening. Or maybe you’ve been getting mammograms for years. Either way, staying informed about the latest guidelines can help you make the best decisions for your health.
“Treatments are both more effective and have fewer side effects when breast cancer is detected early,” says Quynh Le, DO, a PeaceHealth breast surgical oncologist in Bellingham, Washington.
Breast cancer care has improved remarkably in the last 35 years, saving 40% more lives than in 1990. In fact, the current 5-year survival rate is more than 99% when breast cancer is caught early — before it can spread.
When to start screening and how often
How often should you get screened, and at what age should you start?
Recent health guidelines emphasize a personalized approach. Because of this, your screening schedule may be different than your friends and family members.
The ideal plan is to screen often enough to find cancer at its most treatable stage. At the same time, you want to avoid screening too often since it can take extra time and cause unnecessary stress.
One professional group, the National Comprehensive Cancer Network, recommends screenings every year starting at age 40 if you are at average risk. PeaceHealth also recommends breast cancer screenings once a year, based on guidance from the American College of Radiology and the American Society of Breast Surgeons.
The key thing to know is that experts all agree on the importance of regular screening. Here's a general guide by age:
- 25-30: Your doctor might recommend screening this early if you are at high risk for developing breast cancer. High risk can mean having inherited certain genetic changes or having a close relative with breast cancer. If your risk is higher than average, your doctor might also recommend a yearly MRI (magnetic resonance imaging) test.
- 40-49: Talk with your doctor about yearly mammograms. Some people may benefit from starting at 40, especially if you have risk factors such as dense breast tissue.
- 50 and up: Continue getting a yearly mammogram.
Learn more about breast cancer screening.
What affects your risk
When you start and how often you get screened also can be influenced by other things, such as whether you:
- Have a family history of breast cancer, especially with the BRCA gene.
- Have noticed changes in your chest tissue, such as a lump, nipple discharge or changes in skin color or texture.
- Are a member of the Black community. Black women are more likely to develop aggressive forms of breast cancer and at younger ages.
- Have had radiation treatment to the chest, which could increase your risk.
- Have had hormone therapy, which may raise your risk.
To strike the right balance for you, have an open conversation with your doctor or care team. They can help you decide about when to get screened based on your personal needs and risk level.
Learn about factors that may increase your breast cancer risk.
Understanding breast density laws
Legislation in many states, including Oregon and Washington, led to a national rule enacted in 2023 that requires your doctor's office to let you know about your breast density after a mammogram.
This is important because dense breast tissue can:
- Make it harder to see signs of cancer on mammograms.
- Slightly increase your risk of breast cancer.
- Be better suited to additional screening tools like ultrasound and/or MRI.
If you have dense breasts, you also might benefit from:
- More frequent screening.
- Different types of screening tests or scans beyond mammograms.
Don’t worry if you find out you have dense breasts — about 40% of people who get mammograms do. Your doctor or care will help you understand what this means for your screening plan.
Breast health for all
While breast cancer primarily affects people with a significant amount of breast tissue, everyone has some chance of developing it. That's why it's important to have a conversation with your doctor about your personal risk.
Mammograms may be an option for all genders at higher risk. Start the conversation with your care team if you:
- Inherited the BRCA gene.
- Notice unusual changes to chest tissue.
- Have had radiation treatment to the chest.
- Have taken certain types of hormone therapy.
Learn about breast cancer in men.
Screening methods
A monthly self-exam is a good place to start, Dr. Le says. It should be combined with professional screening every year.
The most common way to screen for breast cancer is with a mammogram. This is essentially an X-ray of your breast tissue.
PeaceHealth offers 3-D mammograms (tomosynthesis) in many locations. This is the latest technology available for breast cancer screenings. It creates detailed images that can:
- Find cancers hidden by overlapping tissue.
- Improve accuracy, especially in dense breasts.
- Lower the chances of false positives.
Your doctor also may do an in-office breast exam to find any changes that may not show up on a mammogram. If they want to gather more detail, they might also recommend scans like breast MRI or ultrasound.
Next steps
The decision about when to start and how often to have mammograms is up to you. Work with your care team to look at your family history, genetics and past health conditions. This will help you make an informed choice to protect your breast health.
Whether it's your first mammogram or your 15th, you can breathe easier knowing you've improved your odds against breast cancer.
Quynh P. Le DO
Quynh Le, DO is a board-certified, fellowship-trained breast surgical oncologist at PeaceHealth in Bellingham.
Dr. Le completed her fellowship training in breast surgical oncology at the University of Southern California, with an emphasis on oncoplastic surgery during breast cancer management. She earned her medical degree from Pacific Northwest University of Health Sciences in Yakima, Washington. She completed her general surgery residency at Henry Ford Macomb Hospital in Clinton Township, Michigan. Before joining PeaceHealth, Dr. Le practiced at a major hospital in Seattle, Washington.
Dr. Le obtained her undergraduate degree in biochemistry from Washington State University in Pullman, Washington, where she continues to serve as an associate professor of the Washington State University Elson S. Floyd College of Medicine. She is an active member of the Society of Surgical Oncology and the American Society of Breast Surgeons, keeping current with new technologies and treatment practices and implementing them into her practice.
“I approach all my interactions with my patients the way I would want to be treated,” said Dr. Le about her philosophy of care. “I always want them to know we’re in this together and they’re not alone. Building a strong relationship and trust with my patients is important because my job is a critical first step in eliminating cancer and I want to be able to guide them through this scary and difficult time,” she said.
Dr. Le trained with world-renowned breast and plastic surgeons in oncoplastic surgery while at USC, allowing her to safely remove breast cancer while also providing an aesthetic outcome. She has presented and advised on developing pathways to treat high-risk breast cancer lesions. She also speaks Vietnamese.
In her free time, Dr. Le enjoys golf, snowboarding, cooking, knitting, surfing and traveling.
