ACR: Breast Cancer Risk Assessment Should Start by Age 25

(NewsUSA) - For many women, breast cancer screening begins at age 40, but the American College of Radiology® (ACR®) is urging a much earlier conversation. According to recommendations from the ACR, all women should undergo a formal breast cancer risk assessment by age 25. This shift aims to identify those at higher risk—due to family history, genetic mutations, or other factors—so they can begin personalized screening earlier. Breast cancer remains one of the most commonly diagnosed cancers in the U.S., and early detection has significantly reduced mortality. While annual mammography starting at 40 is standard for average-risk women, risk varies widely. One in eight women will develop breast cancer, and the ACR particularly emphasizes assessments for Black women and women of Ashkenazi Jewish descent, who may face elevated risks or worse outcomes.

“Breast cancer screening is not a one-size-fits-all approach,” said Stamatia Destounis, MD, FACR, chair of the ACR Breast Imaging Commission. She noted that a risk assessment by age 25 can help identify those who may benefit from earlier or supplemental imaging, allowing informed decisions. The ACR also highlights the importance of risk assessment for transgender individuals, whose risk can be influenced by anatomy, hormone use, and other factors. Moreover, among Asian, Black, and Hispanic women, one-third of breast cancers are diagnosed under age 50, underscoring the need for individualized evaluation. To help people take action, the ACR’s Mammography Saves Lives initiative offers resources on risk factors, breast density, and screening questions. For more information, visit mammographysaveslives.org.