TL;DR
Last week we talked about the mammogram you’ve been putting off. This week is for our daughters, nieces and goddaughters. Radiologists now say every woman, and Black women in particular, should get a breast cancer risk assessment by age 25. That is a conversation with a doctor, not a scan, and it decides whether she needs to start screening before 40.
Key Points
- The American College of Radiology moved its recommended age for a breast cancer risk assessment from 30 down to 25, and it named Black women specifically.
- Women found to be at higher risk may need MRI screening starting between 25 and 30, plus yearly mammograms before 40.
- About one in five Black women diagnosed with breast cancer has triple-negative breast cancer, a more aggressive type.
- Louisiana ranks fourth in the nation for the female breast cancer death rate.
- Uninsured or underinsured Louisiana women can get free screening through the Louisiana Breast and Cervical Health Program.
Last week I asked you to stop putting off your own mammogram. Today I want to talk about someone else in your life: the young woman you would do anything for, whether she’s your daughter, your niece or a goddaughter who trusts you with things she won’t tell anyone else.
She is probably 22, or 26, or 31. And she has likely been told the same thing we were told: breast cancer is something to think about at 40.
For a lot of our girls, 40 is too late to start the conversation.
My sister was only 43 when she found a lump on her breast. She immediately went to her doctor and had a procedure. Fortunately they caught everything early and she is fine. But she sees her doctor every year for a followup.
What Changed for Our Daughters
When I was coming up, nobody talked to a 25-year-old about breast cancer. The advice changed, and many families never heard about it.
In 2023, the American College of Radiology updated its guidelines. It now says every woman should have a breast cancer risk assessment by age 25, and it names Black women as a group who especially need one. The earlier guidance said 30. Five years can matter a great deal.
A risk assessment is not a mammogram and it doesn’t hurt. Your daughter sits down with her doctor, and together they look at her family history, her health history and other factors. The doctor uses that information to estimate her lifetime chance of getting breast cancer.
That estimate determines her next steps. If her lifetime risk comes back at 20% or higher, or if she carries a gene mutation like BRCA1, the radiologists recommend MRI screening starting between ages 25 and 30, with yearly mammograms beginning somewhere between 25 and 40 depending on her risk. If her risk is average, she follows the standard schedule. Either way, she knows where she stands. Knowing is a gift.
Why This Matters So Much for Us
Here in Louisiana, breast cancer is the most commonly diagnosed cancer among women and the second leading cause of cancer death. Our state also ranks fourth in the country for the female breast cancer death rate.
For our community, the type of cancer is part of the story too. Roughly 20% of Black women diagnosed with breast cancer have triple-negative breast cancer. It tends to grow fast, and it can return after treatment. A cancer like that doesn’t wait for a 40th birthday, which is exactly why our young women need a plan earlier.
I’m not telling you this to scare anybody. I’m telling you because information is how we protect each other, and our grandmothers didn’t have this information.
How to Start the Conversation
This doesn’t need to be a big sit-down. A simple message works: the doctors changed the advice, they want women checked for breast cancer risk by 25, and will she ask about it at her next appointment?
Then help her get ready. Family history is the most important thing she’ll bring, and you may be the one holding it. Sit down together and write out what you know:
- Anyone in the family, on either her mother’s or her father’s side, who had breast or ovarian cancer
- How old each relative was when they were diagnosed, since cancers that appeared young are especially important to mention
- Any relative who has had genetic testing, and what the results showed
- Whether she has ever had radiation treatment to her chest
That last item surprises people. According to the radiologists, women who had chest radiation before age 30 should begin screening at 25, or eight years after the radiation, whichever comes later.
Our families don’t always talk about illness. Aunties kept diagnoses quiet, and some of our elders called cancer “that thing” and changed the subject. Breaking that silence may be the most loving thing you do this year.
One more thing to tell her: if a doctor waves her off because she’s “too young,” she should ask the doctor to put that decision in her chart, or find another provider. Our daughters deserve to be heard.
Help Is Here in Louisiana
Money should never be the reason a woman skips her screening. The Louisiana Breast and Cervical Health Program provides free mammograms and cervical cancer screenings to eligible women who are low-income, uninsured or underinsured. When a mammogram comes back abnormal, the program also covers follow-up testing such as ultrasound, MRI or biopsy. LBCHP’s current phone number is 1-888-599-1073) and age/income eligibility is ages 40 to 64.
Your daughter may still be under the program’s age range, but you might not be. And our neighborhood community health centers see patients on a sliding scale, whether or not they have insurance. In New Orleans, that includes Daughters of Charity, DePaul Community Health Centers, Excelth and the Thomas Community Health Center, with locations from Gentilly to Algiers.
If she needs support beyond the doctor’s office, Sisters Network, Carrie’s Touch and the Black Women’s Health Imperative were all built for us. Please share their names with your circle.
If you are 40 or older and still haven’t scheduled your own mammogram, last week’s column walks you through it. When we lead by example, our girls follow. And if a parent’s Medicaid renewal is on your list this fall, our guide to Louisiana’s new Medicaid work requirements explains how to protect that coverage.
One Thing to Do Before October Ends
Pick one young woman you love and tell her about the age-25 risk assessment. Then share whatever family history you know, including the parts nobody likes to talk about.
Breast Cancer Awareness Month usually means pink ribbons. It can also mean the next generation hears this information sooner than we did.
This column is for general information and is not medical advice. Talk with your own health care provider about your personal risk and screening schedule.
About the Author
Denise Tureaud is the wellness columnist for Black Source Media. Every Wednesday she writes about health, healing and taking care of ourselves and each other.
Sources
- American College of Radiology: New breast cancer screening guidelines call for earlier screening for high-risk women (May 3, 2023)
- Radiology: Imaging Cancer: Updated ACR recommendations for breast cancer screening in higher-than-average-risk individuals
- Louisiana Department of Health: Breast Cancer Brief (December 2024)
- Louisiana Breast and Cervical Health Program
- BlackHealth.org: Free or low-cost mammograms in New Orleans
- The Hub: Facts About Breast Cancer in Black Women
- The Hub: October Is Breast Cancer Awareness Month (support organizations)
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