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Mammography and breast cancer screening: enabling women to make informed choices

Mammography screening for breast cancer does not offer any proven benefit for the general population under the age of 50, barring any particular risk. Between the ages of 50 and 69, the effectiveness of current screening is limited. Over the age of 70, there is not sufficient available evidence in support of screening.

In 2006, la revue Prescrire produced an in-depth review of the evaluations of the benefit-harm balance of mammography screening for breast cancer. The October issue of la revue Prescrire examines the new evidence published since, which confirms the limitations of mammography screening.

A trial was carried out in the UK including some 160,000 women aged 39 to 49, monitored for more than a decade. It showed no statistically significant reduction in mortality from breast cancer. Screening detects many small cancers, leading to anxiety, investigations and sometimes-invasive treatments, whereas around 25% of these cancers very probably pose little or no threat. Around 25% of breast cancers are still diagnosed between screening sessions, and some via clinical examination. Furthermore, repeated radiation of the breasts can itself lead to cancer.

Overall, for every 2000 women aged 50 to 69 screened over 10 years, at best, one woman has her life prolonged; 10 healthy women who would not have been found to have cancer without screening are diagnosed with breast cancer and treated unnecessarily.

Women have the right to be better informed about the limitations of mammography breast cancer screening.

©Prescrire, 1 October 2007

Source: "Dépistage mammographique des cancers du sein (suite)" Rev Prescrire 2007; 27 (288): 758-762.

See also: "Pour un choix éclairé des femmes dans le dépistage mammographique des cancers du sein" (in French).

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