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IBX Insights

Getting Into the Routine of Breast Screenings

Before the pandemic, the breast cancer screening rate had been steadily rising. In 2020 when the pandemic was at its peak, however, the rate dropped sharply. It’s estimated that that drop translated into 47,517 fewer mammograms and 242 missed breast cancer diagnoses.

Now’s the time to turn those numbers around. I encourage everyone to review their risk factors for breast cancer, talk to their doctor, and get their recommended screening.

Understanding Risk Factors

The more we learn about breast cancer, the more we know about the factors that increase our risk of developing it. And while research has uncovered over 30 well-established risk factors linked to breast cancer, here are a few with the strongest connection.

Gender and age

Being assigned female at birth is the most common risk factor for breast cancer. Age is another common risk factor — the older a person is, the more likely they are to develop breast cancer.

Family and medical history

  • Most people who get breast cancer do not have a family history of breast cancer. But people with close blood relatives (parent, sibling, or child) with breast cancer have a higher risk.
  • Having breast cancer in one breast is a risk factor for developing breast cancer in the other breast.
  • Some breast cancer is hereditary, passing from a parent to a child. The most common inherited cause of breast cancer is from a mutated BRCA1 or BRCA2 gene. People with a BRCA1 or BRCA2 gene mutation have an increased risk of breast cancer.

Hormone therapy

Hormone therapy is linked with an increased risk of breast cancer. People who are using or have used hormone therapy for menopause or gender hormone therapy should talk to their doctor about their individual screening needs.


Though race alone is not a risk factor for developing breast cancer, minorities encounter significant disparities in breast cancer diagnosis and outcomes. Black women have a markedly higher mortality rate from breast cancer, and women of color are diagnosed more often with aggressive forms of breast cancer.

Lowing your risk

While you can’t change many of the risk factors for breast cancer, there are things you can do to help lower your risk.

  • Maintain a healthy weight.
  • Avoid or limit alcohol.
  • Exercise regularly.
  • Eat a diet high in fruits and vegetables and low in red and processed meat/food.
  • Breastfeed

Screening Frequency and Types

Breast cancer screening aims to identify breast abnormalities as early as possible. People whose breast cancer is detected at an early stage have more treatment options and a 90 percent or higher survival rate in the first five years.

While the U.S. Preventive Services Task Force recommends women aged 50 to 74 years with an average risk have a mammogram every two years, I urge everyone to talk to their doctor about their risk factors and when they should start screening. For many, the decision to begin screening earlier — in their 40s — is life-saving.

Types of screenings

  • 2D or 3D mammograms
  • MRIs
  • Breast ultrasounds
  • Genetic testing

In addition to recommended screenings, everyone is encouraged to be aware of what looks and feels normal for their breasts. Breast self-awareness can help you identify changes and differences that you can share with your doctor as soon as you notice them.

Screening Results and Next Steps

For most people, a mammogram won’t show any signs of breast cancer. For some, it will detect an abnormality that requires follow-up investigation. And for even fewer people, it will result in a breast cancer diagnosis.

If your mammogram shows a breast abnormality, the radiologist (the doctor who reads the mammogram) will recommend the necessary follow-up tests. Your primary care physician, gynecologist, or oncologist (as needed) will help further guide and coordinate your care.

Appropriate follow-up on an abnormal mammogram is essential. That way, if it is breast cancer, it can be treated as soon as possible.

Access to Screenings and Care

I wish procrastination were the only barrier to getting recommended breast cancer screenings. Unfortunately, that’s not the case. Lack of insurance, low income, lack of access and transportation to health services, misinformation, and fear can prevent many people from living their healthiest lives possible.

Resources are available to anyone who needs help getting a mammogram, including:

The Affordable Care Act requires all new health insurance plans to cover screening mammograms with no copayment. Health plans must cover mammography every two years for women 50 and older and as recommended by a health care provider for women 40– 49.

IBX members

  • Log in at to find a physician, oncologist, or radiology site.
  • Call a Registered Nurse Health Coach at 1-800-ASK-BLUE (1-800-275-2583) (TTY: 711) to discuss screenings, your cancer risk, or any other health concern.

Routine cancer screening can save lives. So please, find out if you are at risk for breast cancer and make a habit of getting the recommended screening.

Todd Campbell, MD

Todd C. Campbell, MD, FACS, is a Medical Director with Independence Blue Cross in the division of utilization management. He comes to IBC as a board-certified general surgeon with over 15 years of clinical experience in a multitude of practice settings. His areas of focus include surgical quality improvement, care cost savings, utilization management, and collaboration with medical policy on surgical issues. Dr. Campbell enjoys working with the members of the team to improve the health and well-being of its members.