Breast Imaging Recommendations
The Women's Imaging Center recommends the latest guidelines from the American College of Radiology (ACR) and the Society for Breast Imaging.
The ACR recommends annual mammographic screening beginning at age 40 for women at average risk for breast cancer, on the basis of extensive literature review. Women with additional risk factors placing them at higher-than-average risk for developing breast cancer need further consideration for earlier and/or more intensive screening.
Breast cancer is the most common cancer in women regardless of race or ethnicity. One in 8 women in the United States will develop invasive breast cancer. 85% of breast cancers occur in women with no family history. Studies have shown that screening mammograms save lives, reducing mortality from breast cancer by 20-40%.
Frequently Asked Questions
The Women's Imaging Center recommends the latest guidelines from the American College of Radiology (ACR) and the Society for Breast Imaging (SBI). Click here.
The ACR currently recommends annual mammographic screening beginning at age 40 for women at average risk for breast cancer, on the basis of extensive literature review. Women with additional risk factors placing them at higher-than-average risk for developing breast cancer need further consideration for earlier and/or more intensive screening.
Early detection decreases mortality for women with breast cancer.
We follow the ACR Recommendations:
- For women with genetics-based increased risk (and their untested first-degree relatives) or with a calculated lifetime risk of 20% or more, digital mammography, with or without tomosynthesis, should be performed annually beginning at age 30.
- For women with histories of chest radiation therapy before the age of 30, digital mammography, with or without tomosynthesis, should be performed annually beginning at age 25or 8 years after radiation therapy, whichever is later. -
- For women with genetics-based increased risk (and their untested first-degree relatives), histories of chest radiation (cumulative dose of 10 Gy before age 30), or calculated lifetime risk of 20% or more, breast MRI should be performed annually beginning at age 25 to 30.-
- For women with personal histories of breast cancer and dense breast tissue or those diagnosed before age 50, annual surveillance with breast MRI is recommended.-For women with personal histories not included in the above, or with ADH, atypical lobular hyperplasia, or LCIS, MRI should be considered, especially if other risk factors are present.-
- All women, especially black women and those of Ashkenazi Jewish descent, should be evaluated for breast cancer risk no later than age 30 so that those at higher risk can be identified and can benefit from supplemental screening.
Evaluation of a palpable breast mass in a female | |
Age | Imaging Protocol |
< 20 | Ultrasound only |
20-29 | Ultrasound only |
30 < | Bilateral diagnostic mammograms Ultrasound of symptomatic breast |
Evaluation of a palpable breast mass in a male | ||
Age | Imaging Protocol | |
<20 | Ultrasound only | |
20 < | Bilateral diagnostic mammogram (Ultrasound if lesion is not subareolar) |
- For women with elevated risk who would qualify for but cannot undergo breast MRI, adjunctive screening with ultrasound should be considered.
- For women with elevated risk limited to increased breast density, ultrasound can be considered for adjunctive screening, after weighing benefits and risks.
We do not perform breast thermograms, which are not recommended by the ACR for breast screening.

