Screening Guidelines

Memorial Sloan Kettering researchers have developed separate breast cancer screening guidelines: one for women at average risk and one for women at increased risk.

You are at average risk if you have:

  • no symptoms
  • no history of invasive breast cancer (breast cancer that has spread beyond the milk ducts, or lobules); ductal or lobular carcinoma in situ (abnormal cells that are confined to the milk duct, or lobule); or atypia, which is also known as atypical hyperplasia (a form of benign breast disease)
  • no family history in a first-degree relative (parent, sibling, or child) and no suggestion or evidence of a hereditary syndrome
  • no history of mantle radiation (a radiation therapy used to treat Hodgkin’s disease and some other conditions)

You are at above-average risk if you have any of the following:

  • family history of breast cancer (for example, one first-degree relative — a parent, sibling, or child — who has had breast cancer)
  • atypia, also known as atypical hyperplasia (a form of benign breast disease), or lobular carcinoma in situ (abnormal cells that are confined to the milk duct, or lobule)
  • history of having been treated with mantle radiation (a radiation therapy used to treat Hodgkin’s disease and some other conditions) before the age of 32

Our doctors recommend the following breast cancer screening guidelines based on four different levels of risk. They recommend that women in any of these categories perform an optional monthly breast self-examination (BSE) beginning at age 20. They also advise women to be aware of changes in their breasts. If you are at higher-than-average risk for breast cancer, you should discuss with your doctor whether you should have additional screening tests.

If you are at average risk:

  • annual clinical breast examination (CBE) beginning at age 25
  • annual mammography beginning at age 40

If you have a family history of breast cancer:

  • CBE every three to six months starting at the same time as the earliest diagnosis in your family
  • annual mammography starting no later than ten years before the age of the earliest diagnosis in the family (but not earlier than age 25 and not later than age 40)
  • consider annual MRI and mammography at alternating six-month intervals

If you have ever been diagnosed with atypical hyperplasia or lobular carcinoma in situ:

  • CBE every three to six months
  • annual mammography beginning at the time of your diagnosis

If you have had mantle radiation:

  • CBE every three to six months beginning at the time of your radiation treatment
  • annual mammography starting eight years after your radiation treatment
  • consider annual MRI