Breast cancer screening often becomes a priority around age 40, but the American College of Radiology® (ACR®) says one of the most important conversations about breast health should happen much sooner: a breast cancer risk assessment by age 25. According to ACR’s recommendations, this earlier assessment can identify individuals who may benefit from earlier or supplemental screening, potentially improving outcomes through more personalized care.
Breast cancer remains one of the most commonly diagnosed cancers in the United States, and early detection continues to be one of the most effective tools for improving outcomes. Since screening became widespread, breast cancer mortality has declined significantly, helping save countless lives through earlier diagnosis and treatment. While annual mammography beginning at age 40 is recommended for women at average risk, breast cancer risk is not the same for everyone. Factors such as family history, genetic mutations, and other health considerations can increase a person’s likelihood of developing breast cancer and may warrant earlier or additional screening.
One in eight women will develop breast cancer in their lifetime. The ACR recommends that all women undergo a formal breast cancer risk assessment by age 25, with particular emphasis on Black women and women of Ashkenazi Jewish descent, who may face elevated risk factors or worse breast cancer outcomes. Identifying higher-risk individuals early creates an opportunity to develop a more personalized screening strategy before cancer develops.
“Breast cancer screening is not a one-size-fits-all approach,” said Stamatia Destounis, MD, FACR, chair of the American College of Radiology Breast Imaging Commission. “A risk assessment by age 25 can help identify those who may benefit from earlier screening or supplemental imaging. Understanding your personal risk allows people and their healthcare providers to make informed decisions based on their unique circumstances.”
Risk assessment is also important for transgender individuals. Breast cancer risk can be influenced by factors including anatomy, hormone use, family history, genetics, and prior medical care. Healthcare providers can use these factors to develop individualized screening recommendations that reflect each person’s specific risk profile and health history.
Understanding risk is especially important because some populations are diagnosed with breast cancer at younger ages. Among Asian, Black, and Hispanic women, one-third of all breast cancers are diagnosed under age 50, highlighting the importance of evaluating individual risk rather than relying solely on age-based screening recommendations.
Resources are available to help people take that first step. Mammography Saves Lives, an educational initiative of ACR, provides information about breast cancer risk factors, breast density, screening recommendations, and questions patients can discuss with their healthcare providers. Breast Cancer Awareness Month serves as a reminder of the importance of early detection. Learning your risk by age 25 can provide valuable information that helps guide future screening decisions and, for some, may lead to earlier detection when treatment is most effective. For more information, visit mammographysaveslives.org.
