Lost in the arguing over whether women should begin mammograms at 40 or 50 is the issue they will all eventually face: when to stop.
It's an increasingly complex balancing act as older women are living even longer. The risk of breast cancer rises with age. But so do the odds of other serious illnesses that may be more likely to kill in a senior's remaining life span - or to make them less able to withstand cancer treatment.
"If we pick up a cancer in someone who's 75 and they die at 76 of something else, did it really matter? That's really the question here," said Dr Susan Boolbol, breast surgery chief at Mount Sinai Beth Israel Medical Centre in New York.
Medical guidelines do not agree.
The cancer society's advice: women should continue mammograms as long as their overall health is good and they have a life expectancy of at least 10 more years.
Last week, guidelines issued by the US Preventive Services Task Force said there was not enough evidence to recommend for or against mammograms at 75 and older, because that age group had not been studied enough to tell.
Getting such evidence is "critical, given the greying of America", said Dr Jeanne Mandelblatt, an expert on cancer and ageing at Georgetown University.
Some in the 80-and-beyond crowd are as spry as 60-somethings.
"If we don't start discussing it, it's going to be more difficult to come up with management approaches," Yale University pathologist Dr Fattaneh Tavassoli said.
Yale's medical centre is diagnosing more breast cancer at 90 and older, averaging about eight diagnoses a year since 2000, compared with one a year during the 1990s.
Many were diagnosed after the woman or doctor detected an abnormality, not from routine mammograms, Tavassoli said. But she has asked if other hospitals see a similar trend and also wants to study what treatment they underwent.
Mammography does decline as women get older. About three-quarters of women aged 50 to 74 have had a mammogram within two years, compared with 41 per cent of the 85-plus group, according to 2013 US government figures.
Mammograms bring pros and cons for the oldest women, the possibility of reducing breast cancer death versus false alarms, unneeded biopsies and detection of a tumour so small or slow-growing it never would have posed a threat.
Mandelblatt used maths models to analyse that balance, and estimated that healthy older women could benefit from regular screening through age 78 or 80. But among women who already had other moderate-to-severe illnesses the harms of screening could outweigh benefits as early as 68, she said.
If cancer is found in the frail, Mount Sinai's Boolbol notes there are less aggressive options that aim to stop a tumour's growth rather than eradicate it.
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