Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Breast Cancer Screening Information for Women Ages 40 to 49 [Read/Print full article]


Experts don't always agree on when a woman at average risk for breast cancer should start having routine mammograms. Some say she should start at age 40. Others that she should start at age 50. For women between the ages of 40 and 49, it is still not clear if the benefits outweigh the risks. We want to help you make health choices that are right for you.

We recommend:

  • Ages 40 to 49. Women at average risk of developing breast cancer should consider the risks and benefits of routine mammogram screening before deciding.
  • Ages 50 to 74. Routine mammogram screening every 1 to 2 years.

It is important to remember that these guidelines are only about routine screening mammograms for women at average risk.

Routine Screenings

Mammograms aren’t always perfect. But they are the only screening tests that save lives by finding breast cancer early. The benefits vary by age. Here is a list of pros and cons of routine screening for women ages 40 to 49 at average risk.


  • May show what looks like cancerous tumor but is not (false positive).
  • May lead to needless tests (such as a breast biopsy) and anxiety.
  • Can find cancers that are very slow growing that even without treatment, these cancers may never affect your health.
  • Exposes you to some radiation (about the same amount a person would get in normal, daily life in about 7 weeks).


  • One of the best screening tools for finding breast cancer early.
  • Can give you peace of mind.

Risks of Breast Cancer

You may be at higher risk if you have:

  • Personal history of breast cancer.
  • First-degree relative (mother, daughter, or sister) with breast cancer.
  • You or a first-degree relative tested positive for a breast cancer gene.
  • Second-degree (aunt, niece, grandmother, granddaughter) relative with breast cancer before age 50.
  • First- or second-degree relative with ovarian cancer.
  • Prior chest radiation therapy.

If you are at higher risk, talk with your doctor. Your doctor can tell you when to start routine screenings. If you see any breast changes, call the Appointment and Advice line (1-888-454-8855) to make an appointment with your doctor. Or make one online.

How to lower your risk

  • Get moderate exercise (such as brisk walking). Aim for 150 minutes per week.
  • Keep a healthy weight.
  • Eat a diet with fruits, vegetables, whole grains, fish, poultry, and low-fat dairy.
  • Limit alcohol use.
  • Stop smoking.
  • Breastfeed your baby, if you can.

Helping You Decide When to Start

When to start having mammograms is a personal decision. We are here to support your choice. You can use the Additional References to help decide what is right for you. If you have questions, talk to your doctor. If you have decided to begin or continue routine mammograms, you don’t need a referral. Call the Appointment and Advice line (1-866-454-8855) or make an appointment online.

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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