Breast Cancer Screening

Breast cancer screening is a highly effective tool for detecting cancer in its early stages. However, the screening recommendations can be a bit confusing—especially since they have shifted over time.

Niketa Kataria, MD

Dr. Niketa Kataria, radiologist at Riverside Healthcare, provides clarification surrounding breast cancer screening, including timelines, age, and heightened risk.

Understanding Your Risk

Among the average risk population, the American College of Radiology (ACR) and the Society of Breast Imaging recommends annual screening with mammography starting at age 40. In breast imaging, experts stratify women into average risk, intermediate risk, and high risk categories. High risk patients possess a greater than 20% risk of breast cancer, while average risk is less than 15%.

Individuals who should consider breast cancer screening prior to age 40 include those with:

  • genetic mutations such as BRCA1 and BRCA2
  • history of chest wall radiation
  • personal history of breast cancer prior to age 40
  • prior high risk breast biopsy
  • dense breast tissue
  • lifetime risk of breast cancer greater than 20%

New Guidelines From the American College of Radiology

Per Dr. Kataria, lifetime risk is based primarily on family history, with a calculation coming from a breast cancer risk assessment model. In 2023, the American College of Radiology updated its guidelines to state that all women should undergo a breast cancer risk assessment at age 25. This recommendation is based on multiple randomized control trials, observational studies, and U.S. screening data.

Such an assessment is particularly important in Black women, women of Ashkenazi Jewish descent, and other minority women, as these populations tend to have higher likelihood of genetic mutations associated with breast cancers.

“The model takes into account a multitude of factors such as your current age, the age at which you had your first period, breast density, any family history of breast cancer, prior high risk biopsies, just to name a few,” notes Dr. Kataria. “Risk assessment is dynamic. It will change over time based on new information in a patient’s chart, such as breast biopsies or any new additional family history.”

Riverside currently uses the Tyrer-Cuzick model, which is very well studied and validated. “There are many, many models out there, and they each have their own benefits and shortcomings,” she adds.

If a patient is deemed higher than average risk, the recommendation is to undergo annual screening mammography as well as a supplemental screening (MRI, ultrasound).

Making Breast Cancer Screening a Priority

In the United States, one in eight women will develop breast cancer during their lifetime. Breast cancer is the second leading cause of cancer related deaths in women in the U.S. For these reasons, it is critical to proceed with a breast cancer screening strategy appropriate for each individual—but one that begins, at the very least, with the gold standard of mammography.

“This is not just a small subset of women. Breast cancer affects a big population,” cautions Dr. Kataria. “Women should really make their breast health a priority and advocate for their wellbeing. Many women are unaware of their increased risk for breast cancer, and by implementing the new guidelines and the risk assessment model, we really want women to gain a better understanding of their individual risk factors and to really empower them to make informed decisions about their health.”

Prioritize your health. Find the right primary care provider for you here. Schedule your screening today.