What is the earliest age mammography should begin in high-risk patients?

• A. 25
• B. 30
• C. 35
• D. 40

Answer: (B)

In high-risk individuals, imaging strategy often uses two modalities to maximize early detection: MRI and mammography. MRI is more sensitive in younger women with dense breast tissue, so screening can begin earlier for risk assessment. However, mammography is most informative when the breast tissue is less dense, which tends to be after about age 30. Therefore, the earliest age to begin screening mammography in high-risk patients is around 30, typically in combination with annual MRI from an earlier age. Starting mammography earlier (before 30) offers limited additional benefit and exposes the patient to radiation sooner without the same level of diagnostic yield. The later ages would miss opportunities for early detection in high-risk women.