[1] Universal screening with mammography is controversial as it may not reduce all-cause mortality and may cause harms through unnecessary treatments and medical procedures.

The United States Preventive Services Task Force recommends screening mammography in women at normal risk for breast cancer, every two years between the ages of 50 and 74.

[3][4] Several tools are available to help target breast cancer screening to older women with longer life expectancies.

Abnormal findings on screening are further investigated by surgically removing a piece of the suspicious lumps (biopsy) to examine them under the microscope.

Like mammography and other screening methods, breast examinations produce false positive results, contributing to harm.

Doctors suggest that you use the pads of your three middle fingers and move them in circular motions starting at the center of the breast and continuing out into the armpit area.

[10] The European Commission's Scientific Advice Mechanism recommends that MRI scans are used in place of mammography for women with dense breast tissue.

This assertion, however, has been challenged by recent reviews which have found the significance of these net benefits to be lacking for women at average risk of dying from breast cancer.

If suspicious signs are identified in the image, then the woman is usually recalled for a second mammogram, sometimes after waiting six months to see whether the spot is growing, or a biopsy of the breast.

[13] On balance, screening mammography in older women increases medical treatment and saves a small number of lives.

[14] The Nordic Cochrane Collection (2012) reviews said that advances in diagnosis and treatment might make mammography screening less effective at saving lives today.

Women who have mammograms end up with increased surgeries, chemotherapy, radiotherapy and other potentially procedures resulting from the over-detection of harmless lumps.

[3] With unnecessary treatment of ten women for every one woman whose life was prolonged, the authors concluded that routine mammography may do more harm than good.

Some other organizations recommend mammograms begin as early as age 40 in normal-risk women, and take place more frequently, up to once each year.

As of 2009 the United States Preventive Services Task Force recommends that women over the age of 50 receive mammography once every two years.

[3] When less rigorous trials are added to the analysis there is a reduction in breast cancer specific mortality of 0.05% (a relative decrease of 15%).

[24] Because of the importance of breast density as a risk indicator and as a measure of diagnostic accuracy, automated methods have been developed to facilitate assessment and reporting for mammography,[25][26] and tomosynthesis.

[28] All U.S. states except Utah require private health insurance plans and Medicaid to pay for breast cancer screening.

[31] The UK's NHS Breast Screening Programme, the first of its kind in the world, began in 1988 and achieved national coverage in the mid-1990s.

It provides free breast cancer screening mammography every three years for all women in the UK aged from 50 and up to their 71st birthday.

Most women participating in mammography screening programs accept the risk of false positive recall, and the majority do not find it very distressing.

[citation needed] Many patients find the recall very frightening, and are intensely relieved to discover that it was a false positive, as about 90% of women do.

All of these tests have the potential to detect asymptomatic cancers, and all of them have a high rate of false positives and lead to invasive procedures that are unlikely to benefit the patient.

[43] The hypothesis is that focusing screening on women most likely to develop invasive breast cancer will reduce overdiagnosis and overtreatment.

It shows promising results for imaging people with dense breast tissue and may have accuracies comparable to MRI.

[44] It however carries a greater risk of radiation damage making it inappropriate for general breast cancer screening.

A negative MRI can rule out the presence of cancer to a high degree of certainty, making it an excellent tool for screening in patients at high genetic risk or radiographically dense breasts, and for pre-treatment staging where the extent of disease is difficult to determine on mammography and ultrasound.

Also, MRI procedures are expensive and include an intravenous injection of a gadolinium contrast, which has been implicated in a rare reaction called nephrogenic systemic fibrosis (NFS).

[56] It also encourages a referral for counseling and testing in women who have a family history that indicates they have an increased risk of a BRCA mutation, on fair evidence of benefit.

[56] About 2% of American women have family histories that indicate an increased risk of having a medically significant BRCA mutation.