When to Start Mammograms and How Often to Get Screened

By Laurie Incledon, Master of Science in Nursing (MSN)-Advanced Practice Registered Nurse (APRN), Women’s Health Nurse Practitioner (WHNP), Certified Nurse Midwife (CNM), Women’s Health Nurse Practitioner and Certified Nurse Midwife | Updated: October 19, 2026

Disclaimer: Content reviewed and maintained by the clinical team at Women’s Wellness of San Antonio (SA). This content is provided for educational purposes only and is not a substitute for professional medical advice. Consult a qualified healthcare provider.

[!NOTE] Quick Answer / Key Takeaway: All women at average risk should start mammograms at age 40. National guidelines from the American College of Obstetricians and Gynecologists (ACOG), the American Cancer Society, and the U.S. Preventive Services Task Force now all agree on age 40. Talk with your provider to choose the schedule that fits your health history.

When Should You Start Getting Mammograms?

The short answer: age 40. Three major U.S. guideline bodies — the American College of Obstetricians and Gynecologists (ACOG), the American Cancer Society (ACS), and the U.S. Preventive Services Task Force (USPSTF) — now agree that women at average risk should begin screening mammography at 40. This unified starting point reflects newer data showing breast cancer incidence rising by 1 percent per year overall, with an even steeper 1.4 percent annual increase in women under 50. The annual wellness exam is the natural moment to start the conversation about scheduling a first mammogram.

What Age Is Recommended to Start Mammograms?

The answer is 40 for all women at average risk — defined as no personal history of breast cancer, no known breast cancer gene (BRCA) or other genetic mutation, and no prior chest radiation therapy. Guidelines were not always aligned on this point. Previously, USPSTF recommended starting at 50, and ACOG gave women the option to start at 40 or wait until 50. As of their most recent updates, all three bodies have converged on 40.

Women under 40 are not routinely advised to have mammograms because breast tissue is denser — making images harder to interpret — and baseline cancer incidence is lower. Anyone with a specific concern or symptom before 40 should discuss it with a provider.

How Often Should You Get a Mammogram After That?

There is no single frequency that fits every woman. The choice between yearly and every two years involves trade-offs:

• Yearly mammograms detect more early-stage cancers but lead to more callbacks for additional imaging (false positives). Women who value maximum early detection often prefer this option.
• Every two years (biennial) is the USPSTF’s recommended frequency for ages 40 to 74. It reduces cumulative radiation exposure and lowers the chance of false-positive callbacks.
• Shared decision-making is encouraged by ACOG, which advises discussing the interval with a clinician and weighing personal risk tolerance, breast density, and family history.

Mammography reduces the risk of breast cancer death by an estimated 22 percent, according to the Centers for Disease Control and Prevention (CDC). Among women diagnosed at an early, localized stage, more than 99 percent are alive five years after diagnosis. For breast cancer overall, the 5-year survival rate is 91.9 percent.

For women age 75 and older: ACOG recommends continuing screening through at least age 75. After that, the decision should be made with a provider based on overall health and personal preference.

Questions about when to Start Mammograms and How Often to Get Screened? Book an appointment or call 210-858-9767.

When Is Earlier or More Frequent Screening Recommended?

Some women may benefit from starting mammograms before 40 or screening more often than annually. Several risk factors can shift the timing.

Family History and Genetic Risk Factors

• A mother, sister, or daughter with breast cancer roughly doubles or triples a woman’s risk. If that relative was diagnosed before age 50, the risk is higher still.
• Known BReast CAncer gene 1 (BRCA1) or BReast CAncer gene 2 (BRCA2) mutation carriers may need mammograms before age 40, sometimes alternated with breast magnetic resonance imaging (MRI). These women should follow the guidance of a genetics counselor and their provider.
• Anyone with a first-degree relative diagnosed with breast cancer should not wait until 40 to discuss screening. Earlier or more frequent screening may be warranted.

Because BRCA mutations increase risk for both breast and ovarian cancer, genetic testing can offer a fuller picture of a woman’s cancer risk. Women’s Wellness of SA can provide referrals for genetic counseling.

Personal History and Other Risk Factors

• Personal history of breast cancer: Women who have had breast cancer in one breast should follow their oncologist’s screening plan, typically annual mammograms and possibly breast MRI.
• Prior chest radiation: Women who received chest radiation before age 30 (for example, for Hodgkin lymphoma) may need mammograms starting before 40.
• Dense breast tissue: Nearly half of all women have dense breasts, which can hide tumors on a standard mammogram. Texas law requires that women with dense breasts receive a notice after their mammogram. Some choose 3D mammography or supplemental ultrasound.
• Early menstruation (before age 12) or late menopause (after 55): Longer lifetime estrogen exposure slightly raises risk and may factor into the decision to screen annually rather than biennially.

These risk factors are cumulative. More factors may call for more frequent screening, even if no single one is alarming on its own.

Schedule an annual wellness exam to discuss your personal screening plan. A Women’s Wellness of SA provider reviews your health history, performs a clinical breast exam, and connects you to a trusted imaging partner for the mammogram. Book an annual wellness exam

What to Expect During a Breast Cancer Screening

A screening mammogram is a low-dose X-ray of each breast. Here is what a typical experience looks like:

• Before the mammogram: Avoid deodorant, perfume, or powder on the day of the screening. Wear a two-piece outfit. Remove jewelry from the neck down.
• During the screening: Each breast is compressed between two plates for about 10 to 20 seconds per image. A full screening takes 15 to 20 minutes for four images (two per breast).
• Screening vs. diagnostic: A screening mammogram is the routine exam recommended by guidelines. A diagnostic mammogram is ordered when a lump or abnormal finding needs closer evaluation.
• Does it hurt? Most women feel pressure or mild discomfort during compression, but it lasts only seconds. Compression is necessary to obtain a clear image at the lowest possible radiation dose.
• After the exam: A radiologist reads the images. Results are typically available within a few days to two weeks. The imaging center will notify you and your provider.
• 3D mammography (tomosynthesis): Many imaging centers now offer 3D mammograms, which create a layered image and can detect more cancers while reducing callback rates. Ask your referral center whether 3D is available.

Women’s Wellness of SA does not perform mammograms on-site. The practice provides clinical breast exams, education about preventive health screenings, and referrals to trusted partner imaging centers in the San Antonio area. The annual wellness exam is the starting point for the conversation and the referral.

Breast Cancer Screening at Women’s Wellness of SA in Live Oak

Women’s Wellness of SA offers clinical breast exams as part of the annual well-woman visit and provides referrals to trusted imaging centers in San Antonio and Live Oak for the mammogram itself. The process works this way:

• The provider reviews your personal and family health history during the wellness exam.
• A clinical breast exam is performed in the familiar Live Oak office.
• The provider writes a mammogram referral to a partner imaging center offering both 2D and 3D mammography.
• After the mammogram, the imaging center sends results to Women’s Wellness of SA, where the provider can interpret them, discuss findings, and coordinate any follow-up care.

The wellness exam is a single visit that starts the entire screening process. Patients can learn more about breast cancer screening at Women’s Wellness of SA in Live Oak.