You know you’re supposed to get an annual mammogram once you turn 40, but did you know that traditional mammography may no longer be your best screening tool? Researchers have found that digital imaging and magnetic resonance imaging (MRI) may be superior screening methods, depending on age, family history, type of breast tissue and other factors.

Mammograms, which detect breast cancer by film-based x-ray, have saved millions of lives and helped detect many breast cancers in the earliest, most treatable stages. But new technologies are emerging to help individualize breast cancer screening.

Every breast cancer screening method has advantages and disadvantages. An accurate screening test is one that doesn’t miss cancer if it’s present (low false-negative rate) and doesn’t find problems where there are none (low false-positive rate).

So how do you know which method is best for you? Answering that important question starts with understanding your own individual risks for breast cancer and your breast tissue type.

As a woman, you’re at risk for breast cancer. One in 8 women will receive a breast cancer diagnosis in her lifetime. Age is the next most important factor: your risk increases as you age. Most breast cancers occur in women age 50 and older (78%); fewer than one in five breast cancers are found in women in their 40s (17%).

The density of your breast tissue is also an important factor in assessing your risk. A woman with very dense tissue (75% or more tissue density, as determined by mammogram) has a 4 to 6 times increased risk of breast cancer. Young, premenopausal women tend to have denser, less fatty breast tissue. Not only is it harder to see cancer in dense tissue via mammography but cancers are more likely to develop in very dense areas. This is why screening mammograms aren’t typically recommended for women age 39 or younger.

For those women who believe they’re at an increased risk because of a family history of breast cancer, the American Cancer Society points out that a large percentage of American women have one relative who has had breast cancer but that most of these women are at either no increased risk or a minimally increased risk. This is because the majority of breast cancers are related to factors other than genetic mutations.

But for those women with a strong history of breast cancer—about 2% of women—their risk of developing breast cancer is much higher, up to 80% compared with 12% for women in general. Your healthcare provider can walk you through what’s called risk decision models if you’re worried about your family history. These models are designed to predict the likelihood of a genetic mutation associated with breast and ovarian cancer; depending on the outcome, your provider can refer you to genetic counseling services.

Low-tech breast exams: Breast screening starts at home. Although experts are still debating whether monthly breast self-exams actually help detect cancer early, one thing they all agree on is that doing a regular breast self-exam offers you the opportunity to know what is normal for your breasts so that you can promptly report any changes to your provider.

Breast exams done by a healthcare provider are recommended by the American Cancer Society every 3 years for women 39 and younger, and every year for women age 40 and older.

Mammography: Mammograms find cancer before it’s large enough to be felt on self-exam by detecting calcifications, or specks of calcium, in the breasts. These calcifications can come with aging or other changes, but they can also indicate cancer. Traditionally, mammography has been film based, but now digital imaging allows those same images to be stored and evaluated electronically. Research has shown that women who are pre- and perimenopausal get more accurate exams with digital mammography. About one-third of all breast imaging centers now have digital mammography, say FDA experts. If you have the choice, go digital. The procedure is the same (the breasts are compressed between two flat plates), but a digital image is preferred because there’s less chance of missing a cancer. Ask your provider if your previous mammograms have shown a high proportion of dense tissue. If they have, ask for digital mammography. If you’re going to a new center for a mammogram, bring your previous images, whether film or digital. This allows radiologists to compare all of your images, past and present, to improve the accuracy of your diagnosis.

MRI: This technique uses radio waves and a powerful magnet linked to a computer to create detailed pictures of areas inside your body, especially soft tissue. MRIs of the breast are the most sensitive breast screening technique presently developed for clinical use, and they have a low false-negative rate. If an MRI fails to find breast cancer, you can feel more confident that you don’t have cancer. Conversely, MRIs have a higher false-positive rate than mammograms, which means they may find abnormalities that need further investigation but that turn out not to be a problem. This can lead to unnecessary biopsies, follow-up procedures and anxiety. MRIs make some women feel claustrophobic during the procedure; others prefer the scan because breast compression isn’t necessary with an MRI, so there’s no discomfort.

The American Cancer Society recommends that women with a high lifetime risk for breast cancer have an MRI along with their annual mammogram to screen for breast cancer. This means women with strong family histories of breast and ovarian cancer or women who were treated for cancer with radiation to the chest between the ages of 10 and 30. If you fall into this risk group, you should start cancer screening around age 30 (an age that is still debatable among experts, however).

If you’re at intermediate risk, meaning you have dense breast tissue or a family history of breast cancer, there’s no solid evidence showing MRI to be more effective in finding cancer earlier. In this case, talk to your healthcare provider to see whether an MRI should be added to your annual mammography for your most effective cancer surveillance.

If you do decide to have an MRI for breast screening, choose a center with experience in the technique, MRI equipment just for breast screening and the ability to do an MRI-guided breast biopsy, if one is required.

Ultrasound: Many women have ultrasounds of the breast as a follow-up procedure to a suspicious finding on a mammogram or to check a lump found on a manual exam. While ultrasound is a relatively painless way to assess breast tissue, it turns out it’s not very good at finding breast cancer. Ultrasounds don’t provide the same amount of detail that mammograms and MRIs do. They don’t detect calcifications. What they are good at is finding fluid-filled cysts, which is why they’re often used to follow up on a suspicious area found by mammography or MRI.