Who can get breast cancer?

Breast cancer can affect anybody, including people assigned female or male at birth, trans and non-binary people.¹ The chance of getting breast cancer increases as you get older, with the majority of breast cancers being diagnosed in women over 50 years old.²

What is a mammogram? 

A mammogram is an X-ray of the breast which is used as a screening or diagnostic tool for breast cancer.¹ While breast cancer treatments continue to improve, early diagnosis through screening mammograms saves lives by detecting breast cancer as early as possible. Therefore, it is critical to be aware of when and how frequently you are required to get mammograms. 

Screening mammogram vs diagnostic mammogram?

Screening mammogram

Mammograms can be used to check for breast cancer in people AFAB who have no other symptoms of breast cancer.¹ This type of mammogram is a screening mammogram. Screening mammograms involve two or more x-ray images, which make it possible to detect tumors which cannot normally be felt during a physical breast examination. They also enable the identification of microcalcifications that sometimes indicate the presence of breast cancer.¹ Therefore, screening mammograms are useful tools for detecting early breast cancers, which often have better prognosis and are easier to treat. 

Diagnostic mammogram

Diagnostic mammography uses additional imaging techniques used to check for breast cancer following the identification of a lump or other sign or symptom of the disease such as breast pain, nipple discharge or breast skin changes.³ A diagnostic mammogram can also be used to evaluate changes found during a screening mammogram or to view breast tissue when it is difficult to obtain a screening mammogram because of special circumstances, such as the presence of breast implants.¹ 

Why should I get a mammogram? 

Mammograms enable early detection of breast cancer, often even before a lump can be felt. Early detection through mammograms has been associated with a reduction in breast cancer mortality, especially for people assigned female at birth aged 50 and older.⁴ When breast cancer is detected early, there may be more treatment options available, and treatments are often less aggressive than those required for more advanced cancers. Finding breast cancers early with mammography has also meant that many more AFAB being treated for breast cancer are able to keep their breasts, as when caught early, localized cancers can be removed without resorting to mastectomy. 

At what age should I start getting mammograms?

Determining when and how often to get a mammogram depends on age, risk factors, and medical guidelines.³ It is recommended that screening mammograms begin at age 40 for all people assigned female at birth with an average risk of developing breast cancer. This recommendation is on the basis that studies have shown that screening mammography can help reduce deaths from breast cancer among people AFAB ages 40 to 74 years. The benefits of mammograms are strongest for women ages 50 to 69 years. However, people AFAB under the age of 40 with average risk of developing breast cancer are not recommended to have regular mammograms, as no studies to date have shown a benefit from regular screening mammography in women under age 40.¹ 

Why do I not need to get a mammogram before the age of 40? 

False positive mammograms can sometimes indicate the presence of cancer when there is none, leading to psychological stress and additional testing, which may be costly and invasive. False-positive results are more common for younger women. More than 50% of people AFAB screened annually for 10 years in the United States will experience a false-positive result.¹ On the other hand, false negative mammograms can cause cancers to be missed, particularly in younger women due to having dense breast tissue, making mammogram interpretation more difficult.⁶ Dense breast tissue and abnormal breast changes, including calcifications and tumors, can both appear as white areas in a mammogram.⁶

How often should I get a mammogram? 

People assigned female at birth (AFAB) aged between 40 to 49 are recommended to have yearly mammograms.⁵ Following this, people AFAB aged 50 to 74 are recommended to have mammograms every two years, although annual screenings are also acceptable.¹ People AFAB 75 and older, the decision should be personalized based on health status and preferences.¹ 

When should I have an earlier or more frequent mammogram? 

High-risk people AFAB may need earlier and more frequent screenings. It is crucial to consult with healthcare providers to tailor the screening schedule to individual needs and risk profiles. For people AFAB with a high risk of breast cancer, regular mammograms can help monitor and catch any changes or developments early. 

Risk factors 

If you have any of the following risk factors, you are often advised to start having annual mammograms earlier. However, this should be discussed with your healthcare provider.³

• Family history of breast cancer or ovarian cancer
• Inherited genetic mutations (e.g. BRCA1 and BRCA2)
• Benign breast diseases (e.g. atypical ductal hyperplasia and/or lobular neoplasia)
• Dense breast tissue

Should I get a mammogram if I am assigned male at birth (AMAB)

People assigned male at birth (AMAB) may also have a high-risk level because of their family history and, therefore, may also be required to have screening mammography. In general, though, about 1 out of 100 people AMAB develop breast cancer, so it is not advised to follow the same guidelines.¹

Summary 

Breast cancer can affect anyone, including people assigned female or male at birth, trans, and non-binary individuals. It is the most common cancer in the UK, and the risk increases with age, particularly in people assigned female at birth over the age of 50. A mammogram is an X-ray of the breast used for screening and diagnosing breast cancer. Early detection through screening mammograms can significantly improve survival rates and treatment outcomes. Screening mammograms are used to check for breast cancer in asymptomatic people assigned female at birth, typically involving multiple X-ray images of each breast to detect tumors or microcalcifications. Diagnostic mammograms are employed when symptoms or abnormalities are present, using additional imaging techniques for a more detailed examination. People with average risk are recommended to have annual screenings beginning at the age of 40. High-risk individuals with significant risk factors (e.g., family history, genetic mutations) may need to start screenings earlier and have them more frequently. Annual mammograms are recommended between the ages of 40 to 49, and two yearly from the age of 50 to 74. After the age of 75, mammogram frequency is based on health status and personal preferences. Mammograms before age 40 are generally not recommended unless there are high-risk factors. Factors such as family history, genetic mutations, and dense breasts necessitate earlier and more frequent screenings. While breast cancer in people AMAB is rare, those with high-risk factors, such as family history, may need screening. However, general guidelines for people AFAB do not apply.