Many women ≥75 years of age continue to undergo screening for breast cancer despite a lack of evidence supporting this practice. Evidence from the past 5 years suggests rising rates of breast cancer diagnosis in this age group without a corresponding increase in survival — either because the tumour itself is biologically indolent or because life-limiting comorbidities render a biologically aggressive tumour unlikely to further reduce life expectancy. Here, we review what we know, and what we do not know, about screening and overdiagnosis of breast cancer in women ≥75 years of age and build a case for active monitoring for selected screen-detected breast cancers in this population.
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The authors acknowledge funding support provided by the National Institutes of Health (5F30CA264963-04 to NC).
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American Cancer Society Recommendations for the Early Detection of Breast Cancer: https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html
The American Geriatrics Society: Ten Things Physicians and Patients Should Question: https://www.healthinaging.org/sites/default/files/pdf/Choosing.Wisely.Ten_.Things.pdf
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Carleton, N., McAuliffe, P.F. Overdiagnosis, competing morbidity and tumour biology in older women with breast cancer: building a case for active monitoring. Nat Rev Clin Oncol 22, 621–622 (2025). https://doi.org/10.1038/s41571-025-01040-y
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DOI: https://doi.org/10.1038/s41571-025-01040-y
