When should mammograms be discontinued: A guide for women over 70.
- ป้าหมอนุช
- 2 days ago
- 6 min read
The short answer: There is no fixed age to "stop" having mammograms. The decision should be based on life expectancy (over 10 years), overall health, and the patient's own wishes. If you are over 75 but are still healthy and willing to undergo treatment if cancer is found, continued screening is still beneficial. Namarak Hospital recommends consulting a breast surgeon for an individual assessment.
What do international guidelines say about the age at which one should stop having mammograms?
The question of "when should one stop having mammograms?" doesn't have a single answer, even within a global guideline. Each organization offers slightly different recommendations, as follows:
The US Preventive Services Task Force (USPSTF) 2024 recommends mammograms every two years for women aged 40–74 and notes that "there is insufficient evidence" for screening in women aged 75 and older.
The American College of Radiology (ACR) and the Society of Breast Imaging (SBI) recommend annual screenings starting at age 40, with no upper age specified, provided the patient is in good health.
NCCN Guidelines 2026 : For women aged 75 and older, an individual assessment of the benefits and risks should be conducted before deciding to proceed with testing.
The American Cancer Society (ACS) recommends continued screening for as long as a patient has a projected life expectancy of at least 10 years.
The common thread among these approaches is that decisions in old age should be considered on an individual basis, not solely based on age.
Why age isn't the only deciding factor.
Some 70-year-old women are healthier than some 55-year-old women, so using "age" alone as a criterion is unfair. Doctors will consider these factors together:
Overall health — Do you have any serious underlying medical conditions, such as severe heart disease, other cancers, kidney failure, or dementia?
Ability to care for oneself — Are they still able to perform daily routines independently?
Patient's wishes — If cancer is diagnosed, are they willing to receive treatment (surgery, radiation therapy, chemotherapy)?
Risk factors — History of breast cancer, BRCA gene mutation, history of radiation therapy to the chest.
Breast density (dense breast)
A crucial fact that many people don't know is that the risk of breast cancer increases with age. Women over 70 have a significantly higher risk of breast cancer than women over 40. Therefore, stopping screening simply because you "are old" may lead to missing a diagnosis during the peak of the risk period.
What is the concept of "expected life expectancy of 10 years"?
The principle shared across global approaches is that the benefits of breast cancer screening are only realized when patients live long enough.
The scientific reasoning is that breast cancer detected early on mammograms often takes 5–10 years to show an impact on survival rates. Therefore, if a patient has less than 10 years of expected life expectancy (e.g., due to an aggressive or advanced disease), detection may not be beneficial in time. However, the drawbacks of detection, such as false positives, unnecessary biopsies, and overdiagnosis, will occur immediately.
How to roughly estimate expected life expectancy.
Doctors often use tools such as the ePrognosis Calculator or estimate based on:
Current age + Average age of the Thai population (Average life expectancy for Thai women is approximately 80 years)
Number and severity of chronic diseases.
Level of ability to help oneself (functional status)
Example: A healthy 72-year-old Thai woman with no underlying medical conditions and an estimated life expectancy of 15 years — further testing is recommended.
A 72-year-old woman with heart failure and dementia has a possible life expectancy of less than 5 years — she may consider stopping monitoring.
The benefits and drawbacks of mammograms in the elderly.
benefit
Early-stage cancers that are curable have been discovered.
Reduce the mortality rate from breast cancer.
Avoid complex treatments (such as chemotherapy) that are commonly used for advanced cancer.
The punishment must be weighed.
A false positive result — leads to unnecessary repeat biopsies and causes anxiety.
Overdiagnosis — A cancer that grows very slowly and may not cause problems for the rest of your life is discovered, yet you require treatment.
Discomfort during examination — Breast compression may be painful in older women with osteoporosis.
Expenses and time burden.
Research has found that 38% of women aged 75 and older in the U.S. with a life expectancy of less than 10 years still undergo mammograms, reflecting the problem of over-screening that does more harm than good.
In what cases should further testing be considered, even if the person is over 75?
Consider further testing if these characteristics are present:
Overall health is good, with no serious underlying medical conditions.
They are estimated to have a lifespan of more than 10 years.
I am willing to accept treatment if cancer is detected.
Have a history of breast cancer or have high risk factors, such as BRCA mutation.
They can still perform daily routines independently.
For this patient group, annual or bi-annual mammograms still offer clear benefits.
In what cases should we stop testing or reduce testing?
Consider stopping or reducing the frequency of testing when:
They have serious underlying medical conditions that limit life expectancy, such as advanced cancer, severe heart failure, and end-stage renal failure.
Moderate to severe dementia
The patient decided not to receive treatment if cancer was discovered.
Unable to undergo the examination due to physical reasons (e.g., bedridden).
In these cases, testing may be a burden without providing any real benefit.
Shared Decision-Making with Doctors
The decision to stop mammograms is a personal one and should be made after discussion with your doctor. Questions to ask your breast surgeon include:
Is my overall health good enough to benefit from further testing?
If I find a suspicious lump, should I and need treatment?
What is my risk of developing breast cancer?
Are there other testing methods that are more suitable for older adults?
Summary of the decision.
Expected life expectancy — Continue testing: More than 10 years | Consider discontinuing: Less than 5–10 years.
Underlying medical conditions — Continue testing: None or few | Consider discontinuing testing: Multiple severe conditions.
Ability — Continue monitoring: Able to care for oneself | Consider discontinuing: Bedridden or dependent.
Desire for treatment — Continue treatment: Willing to receive treatment | Consider stopping treatment: Does not wish to continue treatment.
Cancer risk — Continue testing: High (BRCA history) | Consider discontinuing: Average
Frequently Asked Questions
Should women aged 75 stop having mammograms?
It is not necessary to stop at age 75 if you are still healthy and expected to live at least another 10 years. Guidelines from the American College of Radiology and the NCCN recommend considering overall health rather than age. A breast surgeon should be consulted for an individual evaluation.
If my mother is 80 years old and in good health, should I continue having mammograms?
If your mother is healthy, has no serious underlying conditions, is self-sufficient, and is willing to undergo treatment if cancer is detected, continued screening can still be beneficial. This could be changed to every two years to reduce the financial burden. It is recommended to discuss your mother's needs directly with her doctor.
Do breast cancer patients who have been cured need to undergo checkups for the rest of their lives?
Women who have had breast cancer are at risk of recurrence, or developing cancer in the other breast. Therefore, they should continue to have annual mammograms as long as their overall health is good and their expected lifespan is sufficient, regardless of age. They should consult their doctor about a personalized monitoring plan.
Even after stopping mammograms, do I still need to perform breast self-examinations?
You should continue to perform monthly breast self-examinations, even after you've stopped mammograms. If you feel a lump, skin changes, a retracted nipple, or nipple discharge, you should see a doctor immediately. Self-examination remains an important tool for monitoring breast health, even in older adults.
Are mammograms more painful in older adults?
Some older adults may experience more pain due to thinner skin and bones, but modern 3D mammograms use less pressure and are more accurate. At Numarak Hospital, our medical technicians are specifically trained to care for the elderly, ensuring the examinations are as friendly and accurate as possible.
Are there breast cancer screening methods that are more suitable for older women than mammograms?
Mammography remains the best standard method currently. Breast ultrasound may be used as a supplement in women with dense breast tissue. MRI is usually only used in high-risk groups, such as those with BRCA status, and is not a general screening method. Consult a breast surgeon for appropriate planning.
About Numarak Hospital
Numarak Hospital is a specialized breast and breast cancer center in Bangkok, providing comprehensive care including screening, diagnosis, surgery, chemotherapy, and in-surgical radiation therapy (IORT) by a team of specialized breast surgeons. If you or a family member are considering whether to continue or stop mammograms, our medical team is happy to provide individual consultations . Schedule a consultation with a doctor.
Content reviewed by: Breast Surgery Team, Numarak Hospital.
Note: This information is for general knowledge purposes only and is not personalized medical advice. Please consult a healthcare professional for proper diagnosis and treatment.
References:
US Preventive Services Task Force. Breast Cancer Screening Recommendation 2024
NCCN Clinical Practice Guidelines in Oncology: Breast Cancer Screening and Diagnosis Version 1.2026
American College of Radiology (ACR) Appropriateness Criteria: Female Breast Cancer Screening 2023 Update
American Cancer Society Breast Cancer Screening Guidelines 2025
Schoenborn NL, et al. Awareness of guidelines on when to stop breast cancer screening. J Am Geriatr Soc 2025
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