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Do I Need a Mammogram Before I Turn 45? YES.

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Wendie A. Berg, MD, PhD, FACR

Breast Cancer / / November 12, 2015

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Recently unveiled guidelines from the American Cancer Society have increased confusion about screening mammography protocol.’s Chief Scientific Advisor and breast imaging expert, Dr. Wendie Berg, weighs in. The organization has developed a simple one page fact sheet that addresses:

Do I Need a Mammogram Before I Turn 45?  YES.

  • The entire reason we screen for breast cancer is to find it EARLY, when most treatable and survivable.
  • Breast cancer is the number one cause of death in women aged 35 to 54 years.
  • Mammography has been proven to reduce deaths due to breast cancer in women screened beginning at age 40.   
  • 25% of all years of life lost to breast cancer occur in women diagnosed before the age of 45.
  • Women at “high risk” for breast cancer due to known or suspected disease-causing mutation (such as BRCA1 or BRCA2) should begin screening at least by age 30, to include MRI.

What About False Alarms (known as “False Positives”)?

  • About 10% of women having a screening mammogram will be called back (recalled) for extra testing or views.  THIS IS NORMAL.  Among women called back, 95% do not have cancer.  If a needle biopsy is necessary, even that is a simple test not much different from a dental filling.
  • Newer techniques such as 3D-mammograms are more able to see cancer and there is less need for recall for extra testing. 

What About Screening in Dense Breasts?

  • Younger women are more likely to have dense breast tissue, which can hide cancer on mammography. 
  • In women who have breasts categorized as “dense”  (heterogeneously dense or extremely dense), adding screening ultrasound after a mammogram can help find more breast cancers.  Because ultrasound detects more, there is more to check and ultrasound does also increase the chance of needing a needle biopsy to determine if something detected is cancerous.  For more information on breast cancer screening, dense breasts and risk factors, please visit

Is it Covered?

  • Insurance is required in nearly all states to cover the full cost of screening mammography. If requested by a health care provider, additional screening with ultrasound, or MRI is generally covered by insurance after a deductible/co-pay, though pre-authorization may be needed for MRI. 
  • Diagnostic mammography is performed to evaluate abnormalities on screening or when a woman has signs or symptoms of breast cancer. A deductible/co-pay will typically apply for diagnostic mammography.



 (c) 2015, DenseBreast-info, Inc. 
Categories: Breast Cancer, Health
About The Author
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Wendie A. Berg, MD, PhD, FACR, is Professor of Radiology at the University of Pittsburgh School of Medicine. Dr. Berg specializes in breast imaging and sees patients at Magee-Womens Hospital in Pittsburgh, PA. Dr. Berg writes and co-edits one of the leading textbooks of breast imaging, Diagnostic Imaging: Breast and has been the Principal Investigator of many important research studies in breast imaging, most notably, with support of the Avon Foundation and the National Cancer Institute, the ACRIN 6666 protocol, which evaluated screening ultrasound and screening MRI in women with dense breasts. Dr. Berg is Chief Scientific Advisor to

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