Should women opt for breast screening despite risks?

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The Independent UK Panel on Breast Cancer screening review has recently published their report on the benefits of breast screening.

It is estimated that around 1,300 lives are saved every year by the existing mammography programme for women between 50 and 70.  The purpose of the screening programme is to advance the time of diagnosis so that prognosis can be improved by earlier intervention.   The Panel estimates of the benefit is the range of one breast cancer death is prevented for approximately 250 women invited to breast screening. 

However, the report has shown that 4,000 women will undergo unnecessary treatment, including surgery, radiotherapy and chemotherapy for a cancer they would not otherwise have known about and which would have done them no harm in their lifetime.  Some breast cancers are so small and slow growing that there would not be a threat to their lives.  The Panel estimates that for every 10,000 women invited to screening from age 50 for 20 years, about 681 cancers will be found of which 129 will represent over diagnosis and 43 deaths from breast cancer will be prevented.

Nevertheless, the Panel's conclusion is that screening extends lives and the programme provides significant benefits to women and it should continue.   A focus group conducted by Cancer Research UK found that women found that the treatment of over diagnosed cancer may cause suffering and anxiety but that suffering is worth the gain from the potential reduction in breast cancer mortality.

Disagreements remain about the relative benefits of breast screening but what is important is that women are provided with all the information available so that they can make an informed choice and understand the harms and the benefits.
Annabelle Eyre
Clinical Negligence Team

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