Do physicians recommend breast cancer screenings based on guidelines?

Expert Guidelines

The National Comprehensive Cancer Network breast screening guidelines recommend the following for women at average risk for breast cancer: 

• ages 25-39: 
  • practice breast awareness
  • clinical breast exam every 1-3 years
  • risk assessment, including questions about family and personal medical history should be done during clinical exam to find high risk women who may need additional screening
• ages 40 and older:
  • practice breast awareness
  • yearly clinical breast exam
  • risk assessment, including questions about family and personal medical history should be done during clinical exam to find high risk women who may need additional screening
  • yearly mammogram - consider 3D mammograms if available. 
• NCCN has a different set of guidelines for individuals who are determined to be at increased risk for breast cancer.

Many other professional societies and organizations have breast cancer screening guidelines that differ slightly. They don't all agree on the age mammogram screening should start and how frequently they should be done. 

It is important to note, that all the groups support the opportunity for women ages 40 to 49 to decide it mammogram screening is right for them.

Questions To Ask Your Health Care Provider

• Are you aware of my family history of cancers?
• At what age do you suggest I begin screening mammograms and why?
• Are there any risks to starting mammograms at a younger age?
• How often should I get screened for breast cancer?
• What should I do if I feel a lump in my breast?

Open Clinical Trials

The following are breast cancer screening or prevention studies enrolling people at high risk for breast cancer.   

• NCT04711109: Denosumab for Preventing Breast Cancer in Women with a BRCA1 Inherited Mutation (BRCA-P). This study will test the effectiveness of a drug (denosumab) on preventing the development of breast cancer in women with an inherited BRCA1 mutation.
• NCT04067726: Denosumab and Mammographic Density in Premenopausal Women With Dense Breasts (TRIDENT). This study is looking at the drug denosumab to learn if it can reduce breast density in high-risk premenopausal women who have dense breasts. 
• The Risk Factor Analysis of Hereditary Breast and Ovarian Cancer In Women  with BRCA1, BRCA2 or PALB2 Mutations.  This study seeks to improve researchers’ understanding of how hormonal, reproductive and lifestyle factors may be associated with cancer in high-risk people.
• NCT02620852: Women Informed to Screen Depending on Measures of Risk (WISDOM) study.  The goal of this study is to determine if breast cancer screening can be made better by personalizing each woman’s mammogram schedule, compared to the current one-size-fits-all, annual approach.

Additional risk-management clinical trials for people at high risk for breast cancer may be found here.