Mammography at age 40? A risk-based strategy
Breast cancer screening starting at age 40 continues to be controversial. Breast density—established with a baseline mammogram—is a key factor in the authors’ algorithmic approach.
For those at low or average risk, things are less clear, and a discussion to determine the appropriate course of screening is needed. Some women with no family history of breast cancer will elect to wait until age 50 to start screening mammography; others may not be comfortable doing so. It is important to point out to patients with very low density (BI-RADS density category 1) breasts that their risk for breast cancer is very low (RR=0.46) and that waiting until age 50 to start regular screening mammography would be a reasonable decision.
