Mammography screening outreach: who to invite, reminder letters, dense breast notices and claims to avoid

Mammography outreach reaches a woman who turned 40 and has never had a mammogram, a patient whose last screening was three years ago, a woman in her late seventies who wonders whether she still needs one, and a primary care or gynecology office deciding where to send its patients. It runs through reminder letters and texts, a booking page, a mobile van at a community center and an ad that says “schedule your mammogram”. Who should the letter invite, and at what interval? What can the page say about 3D mammograms or dense breasts? Can it say a mammogram saves lives, finds every cancer or does not hurt? This guide covers what the U.S. Preventive Services Task Force, Medicare, the National Cancer Institute, MedlinePlus and the FDA say, and the federal advertising, referral and privacy rules that shape a screening outreach program.

Four related topics have their own guides and are not repeated here. Physician referrals, self-referral rules and accreditation claims for an imaging center are covered in our guide to imaging center marketing. Outreach letters, mailed kits and whether a screening letter to your own patients counts as marketing are covered in our guide to colorectal cancer screening outreach. Certificate wording under the Mammography Quality Standards Act, result deadlines, patients without a doctor, Medicare cost lines and running a screening van are covered in our guide to mobile health clinic and mobile mammography marketing. Free screening events and gifts to patients are covered in our guide to health fair and screening event marketing. This guide covers what is specific to mammography outreach. Clinics asked about thermography as a mammogram alternative can use our guide to breast thermography advertising rules. For family history questions and genetic counseling referrals, see hereditary cancer risk assessment outreach.

What USPSTF, Medicare, NCI and the FDA say about screening mammograms

A mammography outreach program starts with who the recommendation covers, what Medicare pays for, what screening can and cannot do and what a certified facility must send the patient. The sources describe it this way:

• The USPSTF final recommendation statement Breast Cancer: Screening (published April 30, 2024) recommends biennial screening mammography for women aged 40 to 74 years (grade B). For women 75 years or older, it concludes that the current evidence is insufficient to assess the balance of benefits and harms (I statement), and it reaches the same conclusion for supplemental screening with breast ultrasound or MRI in women with dense breasts on an otherwise negative mammogram. It says the recommendation applies to cisgender women and all other persons assigned female at birth, including transgender men and nonbinary persons, 40 years or older at average risk, and also to those with factors such as a family history of breast cancer or dense breasts.
• The Medicare.gov page Mammograms (checked October 30, 2026) says Part B covers a baseline mammogram once in a lifetime for women between 35 and 39, screening mammograms once every 12 months for women 40 or older, and diagnostic mammograms when medically necessary. It says the patient pays nothing for baseline and screening mammograms if the provider accepts assignment, and that the Part B deductible and coinsurance apply to diagnostic mammograms.
• The NCI Breast Cancer Screening (PDQ) patient summary (updated December 2, 2025) lists the potential harms of screening as false-positive results, overdiagnosis and overtreatment, delayed diagnosis from false-negative results, and radiation exposure, and says the radiation risk from mammography is very low.
• The MedlinePlus Mammography topic page (last updated May 2, 2025) says regular screening mammograms can help reduce the number of deaths from breast cancer among women ages 40 to 74, that they can find something that looks abnormal but is not cancer, that they can miss cancer, and that the patient and provider can decide together when to start screening and at what interval.
• The FDA page Mammography Information for Patients (content current as of September 10, 2024) says that to legally perform mammography, a facility must be FDA-certified and must post its certificate where patients can see it, and that facilities must send each patient a lay-language summary of the results within 30 days.

Two points shape the marketing. First, the person getting the letter feels well, so the outreach has to invite the right people at the right interval and say plainly what a screening can and cannot find. Second, a mammogram leads to a result, a density notice and in some cases a callback for more images, so the outreach has to tell people what happens after the picture is taken, not just how to book it.

Who gets the invitation, and at what interval

Write the invitation in the words USPSTF uses: a mammogram every 2 years for women aged 40 to 74. Then note the gap between the recommendation and coverage. Medicare covers a screening mammogram once every 12 months for women 40 or older, while USPSTF recommends a 2 year interval, and MedlinePlus says the patient and provider decide together on the interval. So a letter that says “you are due every year” states a coverage rule as if it were the recommendation. Say what the Task Force recommends, say that coverage depends on the plan, and invite the patient to talk with their clinician about the interval that fits them.

For women 75 or older, USPSTF found the evidence insufficient. A reminder sent to that group should not say screening is recommended; it can say that the decision is one to make with their clinician. The recommendation also covers transgender men and nonbinary persons assigned female at birth, so the outreach list and the wording should not leave them out. The Task Force adds that it is calling for more research on screening for Black women, who it says are more likely to die from breast cancer than White women, and that starting screening at 40 is an important first step. That supports outreach through community partners in the neighborhoods the practice serves, not ads targeted by race.

Phrases that need rewriting:

• “Every woman needs a mammogram every year”. USPSTF recommends a mammogram every 2 years for women aged 40 to 74. Quote that and say the interval is a conversation with the clinician.
• “Over 75? Don’t stop now”. USPSTF found the evidence insufficient for women 75 or older. Say the decision is one to make with their clinician.
• “Medicare says you’re due”. Medicare describes what it covers, not what the patient needs. Say what Part B covers and link to Medicare.gov.

Screening, symptoms and diagnostic mammograms

Medicare.gov separates screening mammograms from diagnostic mammograms, which it says investigate abnormalities, including symptoms or signs of breast cancer. NCI says diagnosis can be delayed if someone with a recent normal screening result does not check with their doctor about symptoms. So the booking page and the reminder both need a line for people who notice a change: a lump or another change in the breast is a reason to call their clinician now, not to wait for or book a screening slot.

The cost wording follows the same split. Medicare.gov says the patient pays nothing for a screening mammogram if the provider accepts assignment, and that the Part B deductible and coinsurance apply to a diagnostic one. A flyer that says “mammograms are free with Medicare” leaves out the diagnostic cost and the assignment condition. Say which kind of mammogram the offer covers and whether the facility accepts assignment. Cost lines for other plans and self-pay patients are in our mobile mammography guide, and Medicare marketing rules for the wider practice are in our guide to marketing to Medicare patients.

What a mammogram can and cannot find

NCI lists false positives, overdiagnosis, false negatives and radiation among the potential harms of screening, and says false positives can cause distress and lead to follow-up tests such as biopsies. It also says false negatives are more likely in women with dense breasts. MedlinePlus says a mammogram can miss cancer that is there. Outreach copy that admits this is more honest and easier to defend. It can say what MedlinePlus says about benefit, that regular screening mammograms can help reduce the number of deaths from breast cancer among women ages 40 to 74, and then say that a mammogram can find something that is not cancer and can miss something that is.

A callback for more images is a moment patients fear. Say on the page that some people are asked to come back for more pictures or an ultrasound, that a callback is not a cancer diagnosis, and who will call them and how soon. Describe the facility’s own steps, and keep turnaround times you cannot meet for every exam off the page; the federal result deadlines are in our mobile mammography guide.

Under 15 U.S.C. 45, deceptive acts or practices in commerce are unlawful, and 15 U.S.C. 52 prohibits false advertisements likely to induce the purchase of drugs, devices, services or cosmetics. The FTC staff Health Products Compliance Guidance says claims about the health benefits or safety of health-related products require competent and reliable scientific evidence, and that an advertiser is responsible for the claims its ads convey, including implied ones. A detection rate, a lives-saved figure or a callback rate is a results claim. Leave numbers off the page unless counsel has reviewed the substantiation and the page quotes and attributes the source.

Phrases that need rewriting:

• “Our mammograms detect every cancer”. MedlinePlus says mammograms can miss cancer. Say what screening is for and that no test finds everything.
• “A mammogram saves your life”. Use the MedlinePlus wording: regular screening can help reduce the number of deaths from breast cancer among women ages 40 to 74.
• “No radiation risk”. NCI says radiation from mammography can potentially cause cancer, although the risk is very low. Use that wording.
• “Painless and comfortable”. Describe the exam in the facility’s own words, and say patients can tell the technologist if they are uncomfortable.
• “Results in minutes, total peace of mind”. Say how and when results reach the patient and their clinician, and that a callback can happen.

3D mammograms and dense breasts

USPSTF says both digital mammography and digital breast tomosynthesis, or 3D mammography, are effective screening modalities, and that trials reporting on at least 2 rounds of screening generally found no statistically significant difference in breast cancer detection between them. So a page can offer 3D mammography and describe it. It should not say that 3D finds cancers a standard mammogram misses, or that a 2D mammogram is out of date, unless counsel has reviewed the evidence behind the claim.

Dense breasts now come up in every result letter. The FDA page on the 2023 final rule says enforcement of the amended MQSA regulations began on September 10, 2024, and that the lay summary must include one of two federal density statements. Both start with “Breast tissue can be either dense or not dense. Dense tissue makes it harder to find breast cancer on a mammogram and also raises the risk of developing breast cancer.” The dense version adds that in some people with dense tissue, other imaging tests in addition to a mammogram may help find cancers, and both end by telling the patient to talk to their health care provider. USPSTF found the evidence insufficient for supplemental ultrasound or MRI in women with dense breasts and an otherwise negative mammogram. NCI says it is not known whether supplemental MRI leads to better health outcomes in women with dense breasts.

So an ad for add-on breast ultrasound or MRI that tells every woman with dense breasts she needs one goes beyond what these sources say. Explain what density means using the federal wording, say that the next step is a conversation with the clinician, and describe the extra tests the facility offers without saying they are needed. Whether insurance covers a supplemental test is set by the plan and, in some cases, state by state.

Phrases that need rewriting:

• “3D finds cancers 2D misses”. USPSTF calls both effective and says trials over 2 rounds generally found no statistically significant difference in detection. Describe 3D without the comparison.
• “Dense breasts? You need an MRI”. USPSTF found the evidence insufficient for supplemental screening. Say the patient can talk with their clinician about other tests.
• “Your density letter means you’re high risk”. Quote the federal statement and invite the patient to ask their clinician.

Referrals from primary care and gynecology

A screening program fills through primary care, gynecology and community partners, and its outreach to them is where the federal referral rules apply. Under 42 U.S.C. 1320a-7b(b), the federal anti-kickback statute, it is a crime to knowingly and willfully offer, pay, solicit or receive any remuneration to induce or reward referrals of items or services payable by a federal health care program. Rules on referral fees and fee splitting are also set state by state. Our guide to patient and physician referrals covers the general rules, and our guide to OB-GYN practice marketing covers the gynecology side. For mammography outreach, keep these points:

• Do not pay, discount, place staff in, or give gifts to a referring office or a community partner in return for patients without counsel’s review.
• Referral materials say how to order a screening or diagnostic mammogram, how the report and the density notice come back, and who to call.
• A van visit at an employer or a church is set up with counsel, and the host is not paid per patient screened.
• Practices that see Medicaid patients follow the rules in our guide to marketing to Medicaid patients.

Reminder letters, texts, pixels and ads

A reminder that a screening is due, sent by the practice to its own patient, is part of care. Under 45 CFR 164.501, a communication about a covered entity’s own treatment for an individual can fall outside the definition of marketing, while a mailing that promotes a third party’s product generally needs a signed authorization under 45 CFR 164.508. Keep the reminder short and neutral: a postcard or a text does not need to say “breast cancer” where others can read it. Consent and opt-out rules for texts are in our guide to text message appointment reminders. Check the reminder program with counsel before it goes out.

A mammogram booking reveals a health service, and a form that asks about lumps, family history or past biopsies collects health details. Keep those bookings and page clicks out of tracking pixels and ad platform tools unless a written agreement covers them; our guide to tracking pixels on practice websites covers the setup. The Google Ads personalized advertising policy lists health among its sensitive interest categories and restricts targeting based on it. Public ads can target by place and by search terms, and they should never be built from the practice’s patient list or a screening event sign-up sheet.

Patient stories

A woman whose cancer was found on a screening mammogram makes a powerful story, and it is one person’s result. Under 16 CFR 255.2, an ad that shows one person’s result on a key attribute is likely to be read as what others will generally achieve, unless the practice has substantiation for that or clearly and conspicuously discloses what people can generally expect. Get the patient’s signed authorization under 45 CFR 164.508 where the practice is a covered entity, leave out diagnoses and treatment details the patient has not chosen to share, and do not use a story to suggest that a mammogram finds every cancer. Our guide to testimonials and before and after photos covers the full rules.

Illustration: two mammogram reminder letters

Illustration: a letter reads “Every woman over 40 needs a mammogram every year, and it’s free with Medicare. Our 3D mammograms detect cancers other centers miss, with no radiation risk and no pain. Dense breasts? You need an MRI too. Don’t wait until it’s too late. Click to book and tell us about any lumps or family history.” It overstates the recommendation, treats Medicare coverage as free for every mammogram, makes detection and safety claims, recommends a supplemental test the Task Force found insufficient evidence for, uses fear and collects health details through a web form.

Illustration: a second letter for the same practice reads “Dear [Patient name], our records show it may be time to talk about a screening mammogram. The U.S. Preventive Services Task Force recommends a mammogram every 2 years for women aged 40 to 74; your clinician can help you decide what fits you. A mammogram can find some cancers early, can find something that turns out not to be cancer, and can miss cancer, and some people are asked to come back for more pictures. If you notice a change in your breast, call your clinician now instead of waiting. Our facility is certified under the Mammography Quality Standards Act, and [Physician name] reads the images. Medicare Part B covers screening mammograms for women 40 or older; see Medicare.gov or ask your plan. Call [phone] to book.” It quotes the recommendation, says what screening can and cannot do, points people with symptoms to their clinician and keeps health details off the web.

Checklist before a mammography outreach program starts

• The invitation quotes the USPSTF recommendation with its published date: every 2 years for women aged 40 to 74.
• Women 75 or older are told the decision is one to make with their clinician, not that screening is recommended.
• Medicare wording matches Medicare.gov: screening once every 12 months, nothing owed if the provider accepts assignment, and a separate cost for diagnostic mammograms.
• The page and the letter tell people with symptoms to call their clinician instead of booking a screening.
• No detects-every-cancer, lives-saved, no-radiation or painless claims, and no detection or callback numbers without counsel’s review.
• 3D and supplemental tests are described without comparisons or needs claims, and density wording follows the federal statement.
• No payment, staff or gifts to referring offices or hosts without counsel’s review.
• Reminders are neutral, bookings and page clicks stay out of pixels and ad audiences, and ads are not built from patient lists or targeted by health status.
• Stories have a signed authorization and a disclosure of what people can generally expect where needed.

How we help

We build websites, local search, Google Ads and AI front desk tools for independent practices and health businesses, including practices and imaging centers that run screening mammography. For a mammography program, that means a site that quotes the screening recommendation with its date, explains screening and diagnostic mammograms, callbacks and density notices in plain words, names the physician who reads the images, and gives the Medicare wording from Medicare.gov, plus booking and reminder flows that keep symptoms, family history and insurance numbers off the web and away from tracking tools. We do not decide how care is delivered; your clinicians do. Our tools are built with HIPAA in mind. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it. We are not a healthcare provider and we do not give legal or medical advice. We do not sell lead lists and we do not pay for referrals. For the wider rules, see our healthcare marketing rules hub.

Sources

• USPSTF: Breast Cancer: Screening (published April 30, 2024)
• Medicare.gov: Mammograms (checked October 30, 2026)
• NCI: Breast Cancer Screening (PDQ), patient version (updated December 2, 2025)
• MedlinePlus: Mammography (last updated May 2, 2025)
• FDA: Mammography Information for Patients (content current as of September 10, 2024)
• FDA: Important Information: Final Rule to Amend the Mammography Quality Standards Act (content current as of September 10, 2024)
• 15 U.S.C. 45: Unfair methods of competition unlawful
• 15 U.S.C. 52: Dissemination of false advertisements
• FTC: Health Products Compliance Guidance (December 2022)
• 42 U.S.C. 1320a-7b: Criminal penalties for acts involving Federal health care programs
• 45 CFR 164.501: Definitions
• 45 CFR 164.508: Uses and disclosures for which an authorization is required
• 16 CFR 255.2: Consumer endorsements
• Google Ads: Personalized advertising policy

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