At what age can you stop mammogram screening?

When to Stop Mammogram Screening

Mammography screening should continue as long as a woman has good overall health and a life expectancy of at least 10 years, regardless of age—do not use age 75 as an automatic cutoff. 1

Decision Framework Based on Life Expectancy

The decision to discontinue screening mammography should be based on health status and longevity, not chronological age alone. 1 Here's how to approach this:

Continue Screening When:

• Life expectancy exceeds 10 years and the woman is in good overall health 1
• The woman has no or low comorbidity regardless of being age 75 or older 2, 3
• For women with a personal history of breast cancer, continue annual mammography as long as life expectancy is at least 10 years 4

Consider Discontinuing When:

• Life expectancy is 5-10 years: This requires individualized shared decision-making weighing benefits versus harms 5
• The woman has moderate to severe comorbidities that negatively affect life expectancy 1, 2

Discontinue Screening When:

• Life expectancy is less than 5 years, even in women with a history of high-risk cancers 5
• The woman has severe comorbidities or limited life expectancy where harms clearly outweigh benefits 1, 2

Why the 10-Year Threshold Matters

Mortality benefits from mammography require several years to be fully realized—it takes approximately 10 years before a screen-detected breast cancer may affect survival. 2, 6, 7 Modeling studies estimate only 2 fewer breast cancer deaths per 1,000 women who continue biennial screening in their 70s for 10 years. 2, 6

Evidence Supporting Continued Screening in Older Women

• Women aged 70-74 in good health derive benefit from continued screening, with observational studies suggesting approximately 13 fewer breast cancer deaths per 10,000 women screened over 10 years 2
• Women age 75 and older may continue to benefit from biennial screening if they have no or low comorbidity and life expectancy exceeds 10 years 2, 3
• More than one-third of all breast cancer deaths occur in women diagnosed after age 70 4

Harms That Increase With Age

Overdiagnosis increases with age at screening, with approximately 200 per 1,000 women experiencing false-positive mammograms and 13 per 1,000 experiencing overdiagnosis over 10 years of continued screening. 2, 6 These harms must be weighed against potential benefits, particularly as life expectancy decreases. 6, 7

Screening Interval for Older Women

Biennial (every 2 years) screening provides a reasonable balance of benefits and harms for most older women, particularly after age 55. 1, 2 This reduces the frequency of false-positives while maintaining most of the mortality benefit. 1

Critical Pitfalls to Avoid

• Don't use age 74 as an automatic cutoff—this arbitrary threshold from clinical trials does not reflect individual health status 2, 3
• Don't continue screening in women with severe comorbidities or limited life expectancy—the harms will outweigh any potential benefit 1, 2
• Don't assume all women over 75 should stop screening—women in excellent health with life expectancy exceeding 10 years may still benefit 2, 3

Practical Approach to the Conversation

Beyond age 75, the decision should be made through shared decision-making that includes discussion of:

• The woman's estimated life expectancy based on age, comorbidities, and functional status 1
• Potential benefits (estimated 2 deaths prevented per 1,000 screened over 10 years) 2, 6
• Potential harms (false-positives, overdiagnosis, anxiety from additional testing) 2, 6, 7
• The woman's values and preferences regarding these trade-offs 1