That's the main change in Monday's updated guidelines from the Canadian Task Force on Preventive Health Care.
An analysis also found routine mammography, self-examinations and MRIs had no significant benefit for women aged 40 to 49.
The task force also warned there was potential for harm from over-diagnosis and unnecessary biopsy, particularly for younger women.
"We're trying to reframe this set of guidelines away from a prescriptive approach, which makes a one-size-fits-all recommendation for women based on their age, and change it into a discussion between a woman and her doctor about the potential risks, about the potential benefits, and allow each woman to make a decision that's right for her," said Dr. Marcello Tonelli, the chair of the task force and a professor at the University of Alberta's Department of Medicine, in Edmonton.
P.O.V.
Do you support the idea of less screening for some women? Have your say.
The guidelines cover women up to age 74 who are at average risk, meaning they have:
No previous breast cancer.
No history of breast cancer in a first-degree relative such as a mother or sister.
No known mutations in the BRCA1 or BRCA2 genes.
No previous exposure to radiation of the chest wall.
The new guidelines also recommended a change in how often screening mammograms should be offered for women 50 to 74 — from every two years to every two to three years.
As before, there was no evidence that routine breast self-examination in women with no symptoms of breast cancer reduces the risk of death, the panelists concluded in the Canadian Medical Association Journal.
The Canadian Task Force on Preventive Health Care says that women in their 40s do not need regular mammograms, while women aged 50 to 74 can wait longer between exams - from every other year, to every two to three years.
"We're not trying to come across as saying that breast cancer screening with mammography is not useful," said Dr. Marcello Tonelli, chairman of the task force and associate professor in the department of medicine at the University of Alberta.
"We think it is a potentially useful tool in the fight against cancer. But it's important for women to be informed about the risks and benefits - to know that both are present, that it's not all benefit and to realize, when they make that assessment, the magnitude of what they're talking about.
"If you look at the numbers, you are much more likely to have a false positive result than you are to have your life saved by screening," Tonel-li said. "It's a real benefit, but com-pared with the risk of false positives, it's relatively small."
In some cases false positives can lead to women having part or all of their breasts removed when, in fact, they do not have cancer.
It is the first time the guidelines - published this week in the Canadian Medical Association Journal - have been updated in a decade, and with-in moments of their release dissenting voices emerged.
Critics accused the panel of relying on data from older studies that used now obsolete equipment to under-estimate the benefits of screening.
"People are gradually switching to digital mammography which is better than film at finding cancer - but even places still using film, the film is considerably better than it was in the '60s, '70s and '80s, when all these old trials were done," said Dr. Paula Gordon, a clinical professor of radiology at the University of B.C. and chairwoman of the Canadian Breast Cancer Foundation's B.C./Yukon region early detection working group.
She said the overall reduction of breast cancer deaths from mammography "could be easily in the range of 30 per cent.
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