Mammogram guidance is changing. A Mayo doctor shares what to know about breast cancer screening

Dr. Sandhya Pruthi, a family medicine physician and consultant at the Mayo Clinic Breast Clinic, breaks down what the new guidance means for patients.

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Dr. Sandhya Pruthi, a family medicine physician and consultant at the Mayo Clinic Breast Clinic.
Contributed / Mayo Clinic

ROCHESTER — Last week, the U.S. Preventive Services Task Force issued a draft recommendation that states that women should start screening for breast cancer 10 years earlier than the previous guidelines suggested.

The previous recommendation was that women, in general, should get their first mammogram — an X-ray image of the breasts — at age 50. Now, the task force recommends that patients start at age 40. Starting screenings at this age is something that Mayo Clinic has been doing for years, said Dr. Sandhya Pruthi, a family medicine physician and consultant at the Mayo Clinic Breast Clinic in Rochester.

"To hear the U.S. Preventive (Services) Task Force now come back in alignment with where Mayo has been is really fantastic," Pruthi said.

The push for earlier screenings, Pruthi said, is to catch cases of breast cancer that develop before age 50. According to the American Cancer Society, female patients have a 1 in 48 chance of developing breast cancer before age 50, and that risk increases with age.

"If you want to practice early detection and, by doing so, improving prognosis of these cancers and then reducing deaths from breast cancer, starting in their 40s makes more sense based on the data that they (the task force) must have been looking at and making this change in the recommendation," Pruthi said.


While the task force's new guidance for health providers is to start screening at age 40 and continue screening every two years, Mayo goes a step further in their protocol by recommending mammograms every year. But Pruthi said the frequency of screenings depends on the patient's situation.

"Women, specifically younger women, who have dense breast tissue, having a yearly mammogram to watch for changes makes more sense than someone who has less dense breast tissue where they may be followed every other year with a mammogram," Pruthi said. "I think for the majority of young women in their 40s, they are going to have dense breast tissue, so giving that annual recommendation makes more sense."

Other factors, such as race and family history of breast cancer, contribute to when a patient starts receiving mammograms and how often they get them. Pruthi said upcoming guidelines from the task force suggest that health care providers start having conversations with patients about their personal breast cancer risk at age 25.

"Even amongst African American/Black women, who should actually start screening at 40 — and some of them even earlier — because Black women are more likely to die of breast cancer than whites, they tend to have ... higher mammographic density," Pruthi said.

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For those with a relative who has or had breast cancer, especially before the age of 50, Pruthi said the general screening guidance is that the patient starts receiving mammograms when they are 10 years younger than the age their relative was when they were diagnosed with breast cancer.

When considering the new guidance, Pruthi said that though mammograms are the best tool available for breast cancer screening, sometimes mammograms miss cancers. That's why breast awareness is important, she said.

"That means understanding the familiarity of the normal changes of a woman's breast," Pruthi said. "It's more of awareness in the course of showering and dressing, if you were to see something different or feel some nodularity that you hadn't felt before, that's where going to your primary care provider to have that evaluated (comes in)."

Dené K. Dryden is the Post Bulletin's health care reporter. She previously covered the Southeast Minnesota region for the Post Bulletin. Dené's a graduate of Kansas State University, where she cut her teeth working for the student newspaper, the Kansas State Collegian, and the student radio station, Wildcat 91.9. Readers can reach Dené at 507-281-7488 and
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