While the U.S. breast cancer death rate declined by 43% between 1990 and 2025 following the proliferation of mammograms, per the American College of Radiology, that welcome prolonged decline has leveled off among women ages 40-74 in recent years.
What’s more, ACR officials indicate that the national rate of breast cancers that have progressed to Stage IV by the time of diagnosis “increased significantly” between 2004 and 2021 for all age groups.
It’s amid that climate that May was recently dubbed “Mammography Month” in Pennsylvania by way of a Senate resolution sponsored by Senate President Pro Tempore Kim Ward (R-Hempfield) aimed at prompting organizations and individuals across the state to impart a healthy reminder that the ACR recommends beginning annual breast cancer screenings at age 40.
The stakes are massive.
Nearly 322,000 women will be diagnosed with invasive breast cancer nationwide in 2026, according to the American Cancer Society, with an average of 38 Pennsylvanians a day diagnosed.
A 2019 study published in the National Library of Medicine found that women who undergo screenings had a 60% lower mortality rate 10 years out from diagnosis and a 47% lower mortality rate 20 years out than their unscreened peers with access to equivalent treatments. Additionally, they carried 25% less risk of developing advanced cancer.
Meanwhile, roughly 1 in 4 women aged 50-74 have not undergone a mammogram in the past two years, per the ACS.
AHN diagnostic radiologist Dr. Matt Miller of Sewickley, 39, understands firsthand the life-saving power of a mammogram. While he was attending his first year of radiology school, his wife was diagnosed with breast cancer at just 29.
“Mammograms are the single most effective way to help yourself survive a breast cancer diagnosis,” said Miller. “The best way for us to treat cancer is to detect it early while it’s still small and before it spreads. Mammography helps us do that.”
At his job, he sees their effectiveness every day.
“We detect four to six breast cancers per 1,000 mammograms that we read,” Miller said.
Both his wife’s case and the cases of others he’s treated — including one patient he said was diagnosed with breast cancer in her late teens — evidence that the age 40 starting recommendation on mammograms is more a general guideline than a hard-and-fast rule.
“I encountered a couple of times a year where a person will get their first mammogram at age 40. They’re doing the guidelines, and we find a tiny little breast cancer,” said Miller. “And it’s like, ‘OK, if I would have waited till I was 45 or 50, then who knows where I’d be. I might not even be here anymore. Breast cancer can occur at any age. It’s a bell curve. The peak incidence is in the early 50s.”
Some women, he said, are scared away from screenings by notions of radiation and pain.
“There’s a lot of misinformation out there. Patients are scared of the radiation. I had one patient accuse me one time, ‘I don’t want to get a mammogram because you’re going to cause me to have breast cancer,’ ” Miller recalled. “That couldn’t be further from the truth.
“It is a very, very small dose of radiation that we give with a mammogram. It’s the equivalent of taking a trans-Atlantic flight to Paris. So people aren’t canceling their European trip because of radiation, right? You shouldn’t cancel your mammogram because of radiation.”
The physical nature of the test, he said, has changed over the years as well.
“It’s uncomfortable, but it’s definitely tolerable,” Miller said. “We don’t compress nearly as much as they did when mammography first came out. So patients had mammograms in the ’90s and early 2000s and they got scared away because of the pain of the compression. It’s not nearly as bad as that.”
Those and other misconceptions and knowledge gaps are targets of Mammography Month.
Thermography (digital infrared thermal imaging) tests aimed at detecting breast cancer are not a viable alternative.
“Thermography has never been shown to be a reliable screening tool for breast cancer,” Miller said. “So people think that they get a thermogram and they’re good. I diagnose people monthly who say, ‘Hey, how do I have breast cancer? My thermogram was negative.’ There’s nothing that replaces a mammogram.”
The FDA states explicitly that thermography “has not been shown to be effective as a standalone test for breast cancer screening and detecting early-stage breast cancer.”
Ward has also experienced the benefits of early detection firsthand following her diagnosis during the covid-19 pandemic.
“Our messaging during Mammography Month is simple but powerful: Early detection saves lives. Breast cancer is a diagnosis that changes your life forever,” Ward said. “Fortunately for me, I caught it early and was able to fight, overcome and I am now five years cancer-free.”
Fortunately, Pennsylvania is also uniquely situated when it comes to mammograms.
“Having found gaps in the system through my breast cancer journey, I not only understood the importance of early detection, but also the need to ensure Pennsylvania families have access to no-cost mammograms,” Ward said. ”Pennsylvania is now leading the nation by making sure high-risk individuals have access to critical services without worrying about cost.”
Following a previous push by the Pennsylvania Breast Cancer Coalition in 2023, a law is on the books that renders supplemental breast-cancer detection tests like MRIs, breast ultrasounds and genetic testing and counseling free of charge for high-risk individuals covered by state-regulated insurance. (High-risk currently refers to those with personal or family history of breast cancer or abnormal breast screenings, those with extremely dense breast tissue, and those with heterogeneously dense breast tissue who have one additional risk factor determined by a gene-based risk assessment tool).
Signed into law in November, Act 52 of 2025 will expand on those measures by requiring insurers to cover diagnostic breast imaging and broadening the definition of high-risk individuals by the time of its anticipated full implementation in 2028.
“Early detection should be within reach for every woman,” said PA Breast Cancer Coalition President Pat Halpin Murphy in the release. “Behind every mammogram is a life, a family and a future. When we make mammograms accessible, we protect all three.”
AHN offers free (even for the uninsured), walk-in, script-less breast cancer screenings at eight locations among its 20 breast care centers.
“Any emphasis on mammography and early detection of breast cancer is wanted, needed, and, quite frankly, overdue,” Miller said. “I’m very, very pleased with this new development with the Pa. Senate. I’m hoping that patients will see this announcement and take that as a reminder that ‘Hey, I need to go get my mammogram.’ And if you’re overdue for a mammogram, come get it.”