Breast cancer screening is critical in reducing mortality rates, yet the incidence of the disease continues to rise. Currently, breast cancer is projected to account for 32 percent of all new cancer cases among women in the United States.¹ Alarmingly, about one in three women are not up-to-date with their mammograms.² Experts increasingly emphasize the importance of initiating screenings at younger ages and tailoring recommendations based on individual risk factors, such as ethnicity, which can significantly affect diagnosis and survival rates.

Updated screening recommendations

In response to rising rates of aggressive breast cancers in younger women, the U.S. Preventive Services Task Force (USPSTF) and U.S. Centers for Disease Control and Prevention revised their guidance in 2024. They now recommend mammograms every two years for women aged 40–74.^3,4

Evidence continues to show that earlier detection is lifesaving, with annual screening for women aged 40 to 79 using digital mammography or tomosynthesis reducing mortality by more than 41 percent.⁵

Key statistics

The importance of early detection and equitable access to breast cancer screening cannot be overstated. Here are some vital statistics:

• 1 in 8 women (13.1%) will be diagnosed with invasive breast cancer in her lifetime.²
• In 2025, an estimated 316,950 new breast cancer cases and 42,170 deaths are expected among U.S. women.¹
• Localized breast cancer has a 99% five-year survival rate, compared to 32% for distant-stage disease.²
• Black women have a 38% higher mortality rate than white women despite having a lower incidence of the disease.²
• All racial and ethnic groups have seen drops in breast cancer mortality since 1990, except American Indian/Alaska Native women.²
• Asian American/Pacific Islander women saw a 2.6% annual increase in incidence from 2012–2021.²
• Only 67% of women aged 40+ had a mammogram in the past two years; rates are lowest among American Indian/Alaska Native women (51%) and highest among Black women (73%).²

Provider recommendations drive better outcomes

Providers play a vital role in encouraging adherence to breast cancer screening. Conversations about screening should begin at age 40, with recommendations tailored to each patient’s unique risk factors, including family history, lifestyle, breast density, reproductive history, and prior diagnoses.⁶

For patients at elevated risk, providers may recommend screening earlier or using advanced imaging methods such as breast MRI or ultrasound.⁷

A recent study indicates that perfect adherence to screening guidelines could save up to 4.9 million life-years in the United States, underscoring the significance of proactive provider engagement.⁸

HEDIS measures

The Healthcare Effectiveness Data and Information Set (HEDIS^®)⁹ is a widely used benchmark of health care performance in the United States, measuring how effectively health care organizations provide essential health services.

For breast cancer screening, HEDIS measures assess the percentage of women who receive timely mammograms, as outlined below:

• Population: Women aged 40–74 during the measurement year.
• Screening requirement: At least one mammogram (bilateral or unilateral).
• Screening timeline: From October 1, two years prior to the measurement year, through December 31 of the measurement year.
• Exclusions: Patients who have undergone a bilateral mastectomy or two unilateral mastectomies, or received hospice or palliative care during the measurement year, or are aged 66 or older with advanced illness and frailty, or had gender-affirming chest surgery with a diagnosis of gender dysphoria.

Patient-reported mammograms continue to be acceptable if: (1) The date is documented in month/year or year, (2) Standing orders and location lists can support compliance, and (3) Non-qualifying imaging types ‒ such as thermograms, ultrasounds, and MRIs ‒ are not used.

2025 HEDIS updates. For measurement year 2025, the HEDIS breast cancer screening measure age range has been expanded to 40–74 (from 50–74) to align with USPSTF guidelines, and age stratifications have been introduced (40–49, 50–74, total rate) to improve tracking of screening trends and performance across age groups.¹⁰

Breast cancer screening codes

For your reference, here are the Current Procedural Terminology (CPT^®) codes for breast cancer screening.

Cigna Healthcare^® support for breast cancer education

Your patients with Cigna Healthcare coverage can access, at no charge, the Know Your Lemons^® app, which offers easy-to-understand tools to help both women and men learn how to detect breast cancer early, understand symptoms, and access support after a diagnosis. The app is available through our partnership with the Know Your Lemons Foundation, a global leader in visual health education.

Your patients can download the app and explore the “Know Your Lemons at Work” program by visiting the Know Your Lemons for Early Detection website.

Additionally, we encourage providers to direct their patients to the Breast Cancer web page on Cigna.com (www.Cigna.com/Knowledge-Center > General Health and Wellness Topics: Breast Cancer)  for more information, guidance, and support throughout their breast cancer journey.

Cigna Healthcare coverage

Breast imaging is typically covered at no cost when performed as a preventive care service at in-network locations, which your patients can find by logging in to myCigna.com. Coverage for other breast imaging services will depend on your patient’s Cigna Healthcare benefit plan.

You can learn more about our breast imaging coverage policies and clinical guidelines in our Medical Coverage Policies – Radiology/Breast Imaging Guidelines.

1    Cancer Facts & Figures 2025.

2    Breast Cancer Facts & Figures 2024-2025.

3    Final Recommendation Statement – Breast Cancer: Screening.

4    Screening for Breast Cancer.

5    Annual Breast Cancer Screening at 40 Saves Lives.

6    Breast Cancer Risk Factors.

7    Breast Cancer Screening (PDQ^®) – Health Professional Version.

8    The aggregate value of cancer screenings in the United States: full potential value and value considering adherence.

9    HEDIS^® is a registered trademark of the National Committee for Quality Assurance (NCQA).

10   HEDIS Measures and Technical Resources.