Which of the following statements describes when high-risk patients should begin mammography relative to family history?

• A. Ten years before the youngest affected family member's diagnosis
• B. At age 40 regardless of family history
• C. At age 50 if no family history
• D. Immediately after birth

Answer: (A)

When assessing when to start mammography, the key idea is to tailor the start age to familial risk. If there’s a strong family history of breast cancer, screening should begin earlier than the general population to improve early detection. The standard approach uses the age at which the youngest family member was diagnosed as a reference and starts screening roughly a decade before that age, not before the early adult years. This helps catch cancers that may appear earlier because of inherited risk.

In this scenario, the timing that best fits this concept is to begin screening about a decade before the youngest relative’s diagnosis. That aligns with the principle of adjusting the start age upward for those with higher risk due to family history.

Starting at a fixed age for everyone, ignoring family history, or delaying screening when there is a family history, or starting too early in life, are not appropriate for high-risk patients.