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The problem, says Jayne Charlamb, M.D., director of the Breast Cancer High Risk Program at SUNY Upstate Medical University in Syracuse, New York, is that “we can't yet reliably tell

which cancers will be one that will ultimately go on to kill a patient, and which ones won't.” So some patients end up going through taxing treatments — chemotherapy, radiation,

surgery, medication — “for no good reason,” Charlamb says.   False positives are another risk to breast cancer screening, though these can happen at any age, and, according to a study

published in _JAMA Network Open_, are less likely to happen in older women. Charlamb says an imaging abnormality can lead to additional imaging tests or even a biopsy, and end up being a

false alarm. “And while it's great that the patient doesn't have cancer, we just put the patient under a lot of stress, possibly had her miss work or time with family, and exposed

her to the small (but real) risks of surgery and anesthesia,” Charlamb says. “So, the risk of false alarms is definitely something to weigh.” For some women, IV contrast used in breast MRIs

may cause reactions and unpleasant side effects. “The risk is small, but it's there, and should be considered,” Charlamb adds. AT 75-PLUS, MANY DOCTORS ADOPT AN INDIVIDUALIZED APPROACH

The key for older women, subject matter experts say, is discussing the risks and benefits of screening with your doctor — and understanding that just because mammogram guidelines stop at 75,

doesn’t mean you should stop getting one. In fact, the American Cancer Society recommends that physicians continue to screen older patients who are in good health and who will likely live

10 or more years. “No two women are the same, and that includes women over 74,” says Nina Vincoff, M.D., medical director of the Katz Institute for Women's Health at Northwell Health in

New Hyde Park, New York. “Many older women are in excellent health and lead active quality lives. Just like younger women, they have a lot to lose by developing an advanced breast cancer

that may require debilitating surgery or chemotherapy.”