To Screen or Not to Screen – Getting Clear on Breast Cancer Screening Guidelines

This article is sponsored by Adventist HealthCare

Many women are confused over the latest screening guidelines for breast cancer.  In recent years, several professional groups, including  the American Cancer Society, the U.S. Preventive Services Task Force and the American College of Radiology, have issued updated breast cancer screening guidelines, leaving many women to feel uncertain around whether to get screened and when to get screened.

Age 40 is the best age to start

To help clarify the issue for women, Kamau Foderingham, MD, a radiologist at Adventist HealthCare Imaging Breast Centers in Rockville and White Oak, turns to the screening guidelines set by The American College of Radiology – and the Society of Breast Cancer Imaging.

“These groups say that the most benefit can be achieved if screening starts at age 40,” he explains. “The maximum number of lives are saved when women begin mammograms at 40.”

While, the American Cancer Society recommends annual screenings starting at age 45, with biennial (every two years) screening starting at age 55, Dr. Foderingham still supports the start of mammograms at age 40. “The ACS does state if a woman wants to start screening at age 40, that service should be available to her — even if she is at average risk,” he says. “She does not have to be at high risk. Typically, insurance companies will cover these screenings at age 40.”

Age 40 is the best advice, Dr. Foderingham emphasizes. “A lot of patients are diagnosed in their early 40s, some with their first mammogram, even women at average risk. We can save more lives with early detection. We can give women who are diagnosed with breast cancer the greatest chance for successful treatment and the greatest outcome.”

Earlier screening and MRI for high-risk women

For women at high risk, Dr. Foderingham suggests more aggressive screening.

“High risk” status is calculated based on family history, and a woman may be referred for genetic testing to determine the presence of genetic mutations that could increase the risk of developing breast cancer. These factors determine her risk level; an estimated 20 percent or higher than normal is considered high risk, explains Dr. Foderingham.

“Once a woman has met the high risk criteria, we recommend both annual screening along with a breast MRI. The MRI does not replace the annual mammogram,” he says.

The American College of Radiology recommends high-risk women undergo annual screening at age 30, he adds. “They typically start 10 years before their relative’s age at diagnosis. If her mother was diagnosed at age 40, we recommend mammography starting at age 30. We may recommend MRI annually as well, if she is in the 20 percent threshold.”

“At the Adventist Healthcare Imaging Breast Centers we provide a breast risk assessment that indicates a women’s lifetime risk of having breast cancer. Based on the results of the assessment, it helps us to know how to better manage our patients, which can include using high risk screening protocols with MRI or referral for genetic evaluation,” explains Lori Hartinger, RN, breast cancer navigator for Adventist HealthCare Imaging.

Foderingham adds that insurance companies typically cover the additional cost for MRI if the woman meets criteria for high-risk status.

Learn Your Risk for a Chance to Win a Weekend Getaway!

Take the first step and learn your risk for breast cancer by taking Adventist HealthCare’s free and fast online breast cancer risk assessment. Complete the risk assessment during October for a chance to win a free weekend getaway for two to the Hotel Hershey and Spa in Hershey, PA.  Learn more at

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