Women at average risk of breast cancer should be screened with a mammogram every two years from age 40 through 74, according to the U.S. Preventive Services Task Force (USPSTF), as described by the Centers for Disease Control and Prevention (CDC). This guide explains who counts as average risk, what the test involves, how coverage works and where Maryland residents can look for low-cost options.
What does the CDC say about who should be screened?
The CDC’s screening page, last updated and reviewed on Sept. 22, 2026, states that the USPSTF recommends screening for women aged 40 to 74 who are at average risk for breast cancer. The recommended interval is a mammogram every two years. The CDC adds that women should weigh the benefits and risks of screening with their doctor, and that women at higher than average risk may follow different recommendations.
The CDC describes a mammogram as an X-ray of the breast and says that, at this time, it is the best way to find breast cancer for most women of screening age.
| Quick facts | Detail |
|---|---|
| Recommended ages (average risk) | 40 to 74 |
| Recommended interval | Every 2 years |
| Main screening test | Mammogram (breast X-ray) |
| Source | CDC, page reviewed Sept. 22, 2026 |
What counts as “average risk”?
Average risk means a woman does not have the factors that call for a different screening plan. The CDC’s risk-factor page, also reviewed on Sept. 22, 2026, lists several that cannot be changed:
- Getting older. Most breast cancers are diagnosed after age 50.
- Inherited gene changes, such as BRCA1 and BRCA2, which raise breast and ovarian cancer risk.
- An early start of menstrual periods or late menopause.
- Dense breasts, which can make tumors harder to see on a mammogram.
- A personal history of breast cancer or of certain noncancerous breast conditions.
- A family history of breast or ovarian cancer, especially in a first-degree relative or a relative diagnosed young.
- Chest or breast radiation before age 30, such as treatment for Hodgkin’s lymphoma.
- Exposure to diethylstilbestrol (DES), including in the womb.
Anyone who sees themselves in that list is the kind of person the CDC says may need a different plan, and a clinician is the right person to work out what that plan looks like.
Which risk factors can people change?
The CDC also lists factors that are within a person’s control, at least in part. They include being physically inactive, being overweight or having obesity after menopause, using menopausal hormone therapy with estrogen and progesterone or some birth control pills, and drinking alcohol, where risk rises with the amount consumed. The page also notes that first pregnancy after age 30, not breastfeeding and never having a full-term pregnancy are linked with higher risk, and that smoking, exposure to cancer-causing chemicals and hormonal changes from night shift work may increase risk.
None of this means that lifestyle alone decides whether someone develops the disease. It does mean that screening and everyday habits are separate tools, and that the first does not replace the second. For readers who want to work on the second, the Herald’s guide to high blood pressure and the CDC numbers covers another common condition where habits such as activity and alcohol matter.
Is a mammogram the only screening test?
No, but it is the main one. The CDC describes several tools:
- Mammogram: the primary screening test for most women.
- Breast MRI: used together with mammograms for women at high risk. The CDC says it is not used for average-risk women because it can look abnormal when no cancer is present.
- Breast ultrasound: uses sound waves to create pictures of areas inside the breast.
- Clinical breast exam: a doctor or nurse feels the breasts for lumps or other changes.
- Breast self-awareness: knowing how your breasts normally look and feel, so that changes can be reported. The CDC is explicit that this is not a substitute for screening.
What symptoms should not wait for the next screening?
Screening is for people without symptoms. A change that appears between screenings is a different matter. The CDC’s symptoms page, reviewed Sept. 22, 2026, lists these warning signs:
- A new lump in the breast or underarm
- Thickening or swelling of part of the breast
- Skin irritation or dimpling
- Redness or flaky skin on the nipple or breast
- The nipple pulling inward, or pain in the nipple area
- Nipple discharge other than breast milk, including blood
- A change in the size or shape of the breast
- Pain in any area of the breast
The CDC’s advice is plain: anyone with signs or symptoms should see a doctor right away. It also stresses that these signs can come from conditions that are not cancer, and that no breast is “typical.” Many women’s breasts feel lumpy or uneven, and periods, pregnancy, weight changes, medications and aging can all change how they look and feel. Common noncancerous causes of lumps include fibrocystic changes and cysts. A doctor’s evaluation is how to find out which applies.
Will insurance pay for a mammogram?
For most people, yes. According to the CDC, most health insurance plans must cover screening mammograms every one to two years, starting at age 40, with no out-of-pocket cost such as a copay, deductible or coinsurance. Anyone unsure about their own plan should check with the insurer or the facility before booking.
Insured women should still confirm the details with their plan, but cost should not be assumed to be a barrier. Readers planning other routine prevention this season can also see the Herald’s guide to getting a flu shot in Maryland, and its guide to the 988 crisis line is there for anyone whose health worries are weighing on their mental health.
What if you are uninsured or underinsured in Maryland?
The CDC says it offers free or low-cost mammograms through the National Breast and Cervical Cancer Early Detection Program, with eligibility listed on its page.
In Maryland, the state health department describes a breast and cervical cancer program for the Eastern Shore. Its page lists these eligibility points:
| Requirement | Detail |
|---|---|
| Residence | An Eastern Shore county |
| Age | 40 to 64, or over 65 without Medicare Part B |
| Income | “Limited income” (the page gives no percentage) |
| Insurance | None, or coverage that does not fully pay for breast exams, mammograms or Pap/HPV tests |
Covered services at no cost include clinical breast exams, mammograms, Pap and HPV tests, and follow-up testing and support. The page lists regional phone numbers: 410-778-7970 for the Upper Shore (Kent, Queen Anne’s and Cecil counties), 410-479-8080 for the Mid-Shore (Caroline, Dorchester and Talbot) and 410-548-5175 for the Lower Shore (Wicomico, Somerset and Worcester). The page carries no date, so anyone planning to use the program should call to confirm current rules. Residents of other parts of Maryland can ask their county health department or their clinician what local programs exist.
What should you expect after the exam?
The Food and Drug Administration (FDA) regulates mammography facilities under federal law. Its patient information page, current as of Sept. 10, 2024, says a facility must be FDA-certified to legally perform mammography and must post its certificate where patients can see it.
On results, the FDA page says facilities must send a plain-language summary within 30 days of the mammogram. If the result is “suspicious” or “highly suggestive of malignancy,” the facility must notify the patient of the results and the recommended next steps within seven calendar days of the final interpretation. A callback for more imaging is a common part of the process and does not by itself mean cancer; the doctor reading the results can explain what the next step is for.
How common is breast cancer in the United States?
The CDC’s statistics page, reviewed Sept. 22, 2026, ranks breast cancer as the second most common cancer among women in the United States after some skin cancers, and the second leading cause of cancer death among women, with lung cancer first. For non-Hispanic Black women and Hispanic women, the CDC says, breast cancer is the leading cause of cancer death.
Settling a screening schedule with a clinician
The headline guidance is simple: for average-risk women, every two years from 40 to 74. The practical questions are more personal, including whether family history or breast density changes the schedule, and how to fit an appointment around work and family. Those are conversations for a doctor or nurse, who can place general guidelines against an individual history. For those who have been putting a screening off, the combination of no-cost coverage for most insured women and free programs for eligible Eastern Shore residents removes some of the usual obstacles.
This article is general information, not medical advice. Talk with a health care professional about your own screening needs and any symptoms.
Sources: Centers for Disease Control and Prevention; U.S. Food and Drug Administration; Maryland Department of Health
