Q & A : Which Tests Are Best? When Should I Start?
If I am at high risk for breast cancer, what imaging tests should I be having each year, starting a what age?
- If you have a strong family history of breast cancer (mother or sister premenopausal), start having your mammogram 10 years younger than the age that relative was diagnosed, OR at age 40, whichever is younger; but not before age 25. For example, if your sister had breast cancer when she was 44, you should start having your mammogram at age 34. If your mother had breast cancer at 60, you would start having your annual mammogram at age 40, with perhaps a baseline mammogram at age 35.
If you or your mother or sister have been diagnosed with the breast cancer gene (BRCA1 or BRCA2) you should begin having annual mammograms at age 25, and annual breast MRI sometimes even younger than 25. Your breast doctor should advise you on this.
If you have had Hodgkins disease (lymphoma) in the past, and were treated with radiation to your chest, you should start having annual mammograms 8 years after your treatment was completed. You should also be sent for yearly breast MRI. If you have history of atypical ductal hyperplasia or lobular neoplasia on a prior biopsy, we recommend doing annual MRIs in addition to mammography.
At my practice, we recommend annual mammography and MRI for anyone who has a personal history of breast cancer. This issue is being actively studied and discussed at radiology conferences; our opinion is that there is plenty of evidence to support this recommendation.