I have a patient who wants to have a breast lift. She is 39, and we tell our patients over the age of 35 they have to have a breast mammogram prior to surgery. She “talked to her doctor” who said it was not necessary until age 40. I disagree. The reason? Will go into more below, but I have had multiple patients find cancers, find lumps that need biopsies- real concerns which need to be addressed before cosmetic breast surgery.
When do people usually start getting mammograms?
The usual age to start getting breast mammograms is age 40. This is the standard agreed on for average risk patients by the American College of OB Gyne, US Preventive Services Task Force, American College of Radiology, the Society of Breast Imaging, and the American Cancer society.
So why do we recommend age 35 on up? Because we are doing elective surgery of the breast. That means we are cutting into the breast, and if there were a cancer, could be moving the cancer. Breast cancer under age 40 is relatively uncommon (estimates are 4-11%) but recently rates of breast cancer at younger ages have been slowly increasing.
I am a plastic surgeon in the Bay Area, and many of my patients are not average surgical risk. They have not had kids or had kids at an older age. Many of my breast reduction patients have large, dense breasts. Read below about the increased risk of breast density.
What are dense breasts?
Breasts are made of fat and breast tissue. The more breast tissue = denser breasts. IF YOU HAVE DENSE BREASTS YOU ARE AT AN INCREASED RISK FOR BREAST CANCER. You also may require more imaging to “see” through the dense tissue, like an ultrasound or MRI. See my blogs on breast density.
Top 5 reasons you need a mammogram prior to breast surgery
- We are cutting into your breast tissue. With any breast surgery- breast augmentation, breast lift, breast reduction– we are cutting into breast tissue. With a breast lift and breast reduction, we are really in the breast parenchyma, moving where the tissue sits as we reorient and lift the tissue. You do not want us cutting into a breast cancer. Breast cancer isn’t something that we can see while doing surgery. The cancer tissue can look exactly like the surrounding tissue.
- We find things on the screening mammograms. For many women, this is the first mammogram they have. Is there a mass? Calcifications? Do you need a biopsy? I have had women cancel their surgeries from found breast cancers or abnormalities which required biopsy and work up. And yes, we find things on women in their LATE 30s. If you have a breast implant, is it ruptured? Are your breasts dense and require an ultrasound or MRI? You want to have a great baseline study.
- If you have a benign mass, I may be able to remove it at the time of surgery. I had one patient with 5 benign adenomas I was able to remove at her breast lift. (Note: sometimes I cannot remove it as it is in the blood supply pedicle, or it is not palpable)
- This is elective surgery. Safety is paramount.
- You won’t be able to do a mammogram for 6 months after the breast surgery. After surgery, particularly after a breast lift or reduction, you need to be fully healed before you have the lovely compression needed for a mammogram.
Dr. Greenberg’s final thoughts on breast mammograms
Breast cancer hits 12% of all women. 1 out of every 8 women. If you have dense breasts, which particularly many of my breast reduction patients do, that risk doubles to 25%. Many of my Palo Alto and Menlo Park patients had kids at an older age or didn’t have children. That also increases your risk.
Screening is so important, and we have had many patients find things on their initial screen, even when under the age of 40 with no prior family history or risk factors.
Safety is key when doing elective surgery. I like boring, uneventful surgeries and healing. Be exciting at a cocktail party, not in my OR.
The information provided on this website is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider for any questions regarding your health or medical condition.
