Breast cancer screening has long been a pillar of women’s health, aimed at detecting cancer early and improving outcomes. However, recent findings suggest that routine screening for women beyond the age of 70 may not always provide the intended benefits. In some cases, it might even pose risks, leading to important conversations about how to tailor screening strategies to individual needs.

Emerging Evidence on Screening in Older Women

A large-scale study recently examined breast cancer diagnoses in women over 70 and found a trend that challenges conventional screening practices. While mammograms are widely promoted for early detection, the study highlighted that as women age, the likelihood of overdiagnosis significantly increases.

Overdiagnosis refers to the identification of cancers that would never have progressed or caused symptoms during a woman’s lifetime. These cancers may remain dormant or grow so slowly that they would not impact health or longevity. Despite their harmless nature, the act of diagnosing them often triggers a chain of further tests, biopsies, and potentially aggressive treatments like surgery, radiation, or chemotherapy.

The Physical and Psychological Impact of Overdiagnosis

For many, a breast cancer diagnosis can be life-altering—not just physically, but emotionally. Women recalled for additional imaging or invasive testing after a suspicious mammogram can experience significant anxiety. And when treatment follows, the stress intensifies. The reality is that unnecessary treatments for harmless tumors can result in complications, pain, fatigue, and reduced quality of life, particularly for older adults.

From a public health perspective, overdiagnosis also has broader implications. It consumes resources and shifts attention from individuals who might benefit more from intensive intervention.

A Closer Look at the Study

Researchers analyzed the outcomes of more than 50,000 women aged 70 and above, separating them into three age groups: 70–74, 75–84, and 85 and older. The data revealed that screened women across all age groups were more likely to be diagnosed with breast cancer than those who weren’t screened. More importantly, the risk of overdiagnosis increased with age.

This pattern emphasizes a critical point: the detection of a cancerous lesion doesn’t always equate to a meaningful health benefit—especially when that lesion wouldn’t have progressed or caused harm.

Limitations of the Data

While the study sheds light on overdiagnosis, it focused specifically on that aspect and didn’t assess the full spectrum of benefits and risks associated with continued screening. Therefore, it should not be used to suggest that all older women should stop getting mammograms. Rather, it reinforces the importance of personalized care.

Diverse Guidelines and Mixed Messaging

One of the challenges facing women and healthcare providers is the lack of consensus among leading health organizations. Each provides different guidance on when to stop breast cancer screening:

  • Some recommend discontinuing routine screening after age 75.

  • Others suggest continuing as long as a woman is in good health and has a life expectancy of at least 10 more years.

  • Some experts advocate for ongoing screening unless other serious health issues limit life expectancy.

These varied perspectives reflect a key issue: aging is not uniform. Some women in their 80s remain highly active and healthy, while others experience significant physical decline much earlier.

The Gap in Research

A major contributor to the uncertainty is the lack of robust data on older populations. Many foundational clinical trials that shaped today’s screening guidelines excluded women over 70. As a result, healthcare providers have limited evidence to guide their recommendations for this demographic.

Factors That Should Guide Screening Decisions

Given the complexities, decisions about breast cancer screening in older women should be based on more than just age. Key considerations include:

  • Overall health: A woman’s current medical conditions and expected longevity play a major role.

  • Functionality: The ability to undergo mammography procedures comfortably and safely.

  • Personal and family history: Women with a history of breast cancer or high genetic risk may benefit from continued screening.

  • Treatment preferences: A woman may wish to continue screening for peace of mind, even if she doesn’t plan to undergo invasive treatment if cancer is found.

  • Emotional well-being: Anxiety around health status or mammogram results can influence the desire for ongoing surveillance.

The Role of Shared Decision-Making

What’s clear is that screening decisions should not be one-size-fits-all. Instead, women should be encouraged to speak with their healthcare providers to evaluate the risks and benefits in the context of their individual situation. Physicians can help assess how much a patient stands to gain—or potentially suffer—from continued screening.

For example, some women may feel more comfortable stopping mammograms after 75 if they have no risk factors and face other pressing health issues. Others may feel reassured by annual screenings, regardless of their statistical benefit.

Screening Without Pressure

Importantly, deciding to stop regular screening doesn’t close the door to future action. If a new lump or symptom appears, diagnostic imaging is still a valid and necessary tool. Screening in this context is different from routine, preventive testing—it responds to a specific concern rather than a general possibility.

Likewise, undergoing a mammogram does not obligate a patient to pursue treatment. If cancer is detected, a woman can choose how (or whether) to proceed with care based on her goals and values.

Conclusion

As women age, decisions about breast cancer screening become more nuanced. While mammograms remain a vital part of preventive care for many, recent research calls attention to the potential downsides of continuing this practice beyond a certain age.

Rather than following universal rules, healthcare should adapt to the individual—taking into account health status, preferences, and quality of life. Thoughtful, informed discussions between women and their providers are essential. By aligning care with personal goals and medical realities, women can avoid unnecessary interventions while still protecting their well-being.

Ultimately, aging does not mean an end to good healthcare—it simply means tailoring it more carefully to meet changing needs.