Breast cancer is a disease caused by abnormal (not normal) cells growing in your breast. These cells can cause a tumor to form. You may be able to feel this tumor as a lump under your skin. But you also may not know it’s there unless you have a screening test that shows the tumor. Screenings can help find breast cancer early when it’s easier to treat. Read more about breast cancer.
What are the Screening Tests for Breast Cancer?
Screening mammograms use low-dose X-rays to take images of your breasts. At MSK, screening mammograms are done using 3D mammography, also known as tomosynthesis. Other imaging tests are ultrasound, contrast mammography and MRI. Having breast exams by your healthcare provider is another way to screen for breast cancer. They should be done along with the imaging tests. Learn more about breast cancer screening exams offered at MSK.
What is My Risk for Breast Cancer?
Knowing your risk for getting breast cancer will help you decide when screening is right for you. Ask your healthcare provider about your risk of getting breast cancer in your life. This is called your lifetime risk. Your lifetime risk tells us if you are at average, intermediate, or high risk for getting breast cancer. Depending on your risk, MSK has different guidelines for the type and timing of your screening.
Most breast cancers occur in people who were assigned female at birth. However, people of all genders can get breast cancer. For example, if you are a transgender man or a nonbinary person, you can still be at risk. This is true even if you had top surgery. People assigned male at birth also can get breast cancer.
Average Risk for Breast Cancer
If you were assigned female at birth (your gender now does not matter) and you do not have:
- A hereditary syndrome, such as a mutation (change or variant) in your BRCA or other genes. You may have a hereditary syndrome if your blood relatives had breast, ovarian, or other types of cancers.
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A history of:
- Invasive breast cancer or ductal carcinoma in situ (DCIS).
- Atypical hyperplasia or lobular carcinoma in situ (LCIS). This is a type of breast disease that is not cancer.
- Dense breasts. A mammogram will show if you have dense breasts.
- Breast cancer in your family (blood relatives). This is different for everyone. Your risk will be assessed by your healthcare provider.
- Radiation therapy to your chest when you were young.
Intermediate Risk for Breast Cancer
If you were assigned female at birth (your gender now does not matter) and you have or had:
- A history of breast cancer and are over the age of 50.
- A few relatives with breast cancer, but without abnormal genes.
- Dense breasts. A mammogram will show if you have dense breasts.
- A history of atypical hyperplasia (ADH) and lobular neoplasia. This includes lobular carcinoma in situ (LCIS) or atypical lobular hyperplasia (ALH).
High Risk for Breast Cancer
You’re at high risk if you were assigned female at birth (your gender now does not matter) and have or had:
- A history of breast cancer in your family (blood relatives). This is different for everyone. Your risk will be assessed by your healthcare provider.
- Radiation to your chest before age 32.
- A mutation (change or variant) in your BRCA or other genes.
- Dense breasts. A mammogram will show if you have dense breasts.
- A relative who carried a mutation but you have not had a genetic test.
You’re at high risk if you were assigned male at birth (your gender now does not matter) and have or had:
- Radiation to your chest.
- A disease linked to high levels of estrogen, such as cirrhosis (liver disease) or Klinefelter syndrome (a genetic disorder).
- A history of breast cancer in your family (blood relatives). This is different for everyone. Your risk will be assessed by your healthcare provider.
- Changes (mutations or variants) in genes, such as BRCA1 or BRCA2.
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Gender affirming therapy with feminizing hormones. More research is needed to understand how hormone therapy affects your risk for cancer. You may be at high risk if you also:
- Have been taking feminizing hormones for many years.
- Have 1 or more relatives who had breast cancer.
MSK’s Screening Guidelines for Breast Cancer
These are MSK’s latest guidelines for breast cancer. They may be different from those of other groups of experts. We use an approach that saves the most lives. The type of screening you have and your screening schedule are based on your personal risk for breast cancer.
If You’re at Average Risk for Breast Cancer
- Starting at age 20, become familiar with how your breasts look and feel. Knowing your breasts will help you notice changes.
- Get a breast exam from your healthcare provider every year starting at age 25.
- Starting at age 40, have a mammogram or tomosynthesis (3D mammogram screening) every year. First, talk with your healthcare provider about the pros and cons of getting screened. If your mammogram shows you have dense breasts, they may recommend additional screening tests. These can include an ultrasound or a mammogram with contrast. Contrast is a special dye used in imaging scans that makes it easier to see differences in your breasts.
If You’re at Intermediate Risk for Breast Cancer
- Starting at age 20, become familiar with how your breasts look and feel. Knowing your breasts will help you notice changes.
- Starting at age 25, get a breast exam by your healthcare provider every 6 months.
- If you have or had atypical hyperplasia (ADH) or lobular neoplasia, start getting screened at age 30. If you were diagnosed at age 30 or older, start getting screened at the time of diagnosis.
- Get a mammogram or tomosynthesis every year.
- Your healthcare provider may recommend more imaging, such as an ultrasound, contrast mammography, or an MRI especially if you have dense breasts.
If You’re at High Risk for Breast Cancer
- Starting at age 20, have a breast exam by your healthcare provider every 6 months.
- Have a mammogram or tomosynthesis every year. Start no later than 10 years before the youngest age that a close blood relative was diagnosed with cancer. Do not start earlier than age 25.
- Have an MRI every year and alternate with a mammogram every 6 months.
- If you had radiation treatment, have your MRI, and mammogram or tomosynthesis, at the same time or every 6 months. Screening should begin 8 years after radiation treatment.
- If you had top surgery and were assigned female at birth, talk with your healthcare provider about screening. You probably have breast tissue.
- If you’re having or had gender affirming hormone therapy, talk with your healthcare provider about screening.
