There is an established consensus in the breast health community that mammography is the mainstay imaging examination for screening breast cancer. However, there are varied national recommendations among stakeholders and major institutions in the topic of breast cancer screening. Lack of consensus in screening criteria includes risk stratification, age to initiate screening, and the interval of screening. The differences in practice guidelines are mainly due to variation in design and interpretation of screening trials over the past decades. As debates for and against the use of screening mammography continue to escalate, both providers and patients are often confused and wrongly perceive the recommendations as directives. The purpose of this article is to review the current guidelines, analyze the reason for the controversies in screening mammography, and shine light on the upcoming trends of future screening guidelines.