The question of when to stop mammograms, particularly for women in their 70s and 80s, isn’t always met with a clear consensus among experts. However, being well-informed about the recommendations of leading experts can equip you for meaningful discussions with your trusted primary care provider.
Why You Need Mammograms
Breast exams during your annual wellness checkup with a primary care provider (PCP) or gynecologist are a great way to check your overall breast health. Although sometimes your provider or even you can detect a lump in your breast that turns out to be cancer, it’s not the most reliable way to check for breast cancer. That’s why experts recommend screening mammograms for women as they grow older and their risk of breast cancer increases.
Mammograms are a special type of X-ray that gives physicians a clearer picture of your breast tissue. 3D Screening mammograms help detect cancer at its earliest stages when it is more easily treated. Radiologists can see tumors on a mammogram up to three years before you or a doctor would be able to feel a lump.
When to Start Mammograms
When you should start mammograms depends to a certain extent on your known risk for breast cancer. Recommendations are based on average risk, and there’s no one right answer. What’s right for you may not be right for your best friend or even your sister. Physician organizations recommend that women 25 and older discuss their risk factors for breast cancer with their medical providers to determine what age is best for them to start screening. Important risk factors to discuss with a doctor include:
- A personal history of breast cancer
- A strong family history of breast cancer
- Certain genetic mutations, such as those in the BRCA1 and BRCA2 genes
- Chest radiation before age 30
If you have an average risk of breast cancer, breast health experts recommend starting annual screenings at age 40. A recent study from the Cancer Intervention and Surveillance Modeling Network (CISNET) confirmed the greatest benefits of annual mammography screenings beginning at 40 and continuing through 79 for women with an average risk of breast cancer.
Women at high risk of breast cancer may also need supplemental screening like breast MRI or screening breast ultrasound for optimal early detection.
Mammograms Past 50 and Above
According to the National Comprehensive Cancer Network (NCCN), women should continue annual mammograms as long as they are in good health. However, most cases of breast cancer are detected in women in their 50s and 60s. It’s important to discuss your personal risk factors with your primary care provider or OB-GYN.
If you are a breast cancer survivor, guidelines recommend continuing with annual mammograms as long as you are in good health, in consultation with your oncologist.
Stopping Mammograms
Deciding when to discontinue mammograms is a crucial decision. Patients should discuss the benefits and potential drawbacks with their primary care physician or OBGYN to make an informed decision. According to the NCCN, women with a life expectancy of less than 10 years or those with significant comorbidities that restrict their ability to undergo treatment may consider stopping mammograms. However, every patient is different, and the choice to stop mammograms relies on a variety of factors:
- As women age, life expectancy becomes a crucial factor. If a woman’s life expectancy is limited due to age or existing health conditions, the potential benefits of detecting small, slow-growing cancers through mammography may diminish compared to the potential harms of overdiagnosis and overtreatment. The U.S. Preventive Services Task Force’s guideline is for women to continue screening if they expect to live at least 10 years more.
- Older women may have complex health situations. Someone may not be able to physically withstand breast cancer treatment if diagnosed in their 70s and may choose to stop screenings to prioritize their remaining quality of life over aggressive cancer detection.
It is important for women to discuss their individual risk factors, breast health needs, and personal preferences with their healthcare provider to make an informed, personalized decision about when to stop mammograms.
