When do NCCN and ACS recommend stopping mammography?

• A. At age 75
• B. When life expectancy is less than ten years
• C. After 20 years of screening
• D. When the patient is diagnosed with another cancer

Answer: (B)

The main idea is that cancer screening should continue only as long as the expected benefit outweighs the harms. In mammography, the benefit is the potential reduction in breast cancer mortality, which takes time to translate into real survival gains. When a patient’s remaining life expectancy is less than about ten years, most women are unlikely to receive a mortality benefit from continued screening, and the harms become more prominent: false positives, unnecessary biopsies, anxiety, and exposure to screening-related procedures. That balance is why major guidelines from organizations like NCCN and the ACS advise stopping screening when life expectancy drops below ten years, rather than sticking to a fixed age.

This perspective also reflects that there isn’t a universal age cutoff. Some individuals with substantial health and longer life expectancy may continue screening, while others with limited life expectancy may choose to stop earlier based on overall health and preferences. The key criterion is the expected longevity, not an arbitrary age or a single medical diagnosis.