Breast cancer screening: does it do more harm than good?

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A lay-friendly video summary of Bleyer A & Welch HG. Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence.

• Format Videos
• Language/s English
• Target Audience Self-directed learning
• EBM Stage 4 - Decision making
• Duration 5-15 mins
• Difficulty Advanced

Key Concepts addressed

• 1-2j Earlier is not necessarily better

Details

Women have been screened for breast cancer for over three decades. Some argue that screening does more harm than good because the early cancer detected is “pseudo disease”, in other words, a form of breast cancer that is unlikely to cause the patient a serious problem in the future.

In 2012  the New England Journal of Medicine published new research into whether screening causes overdiagnosis or helps prevent advanced cancers. The researchers found that detecting breast cancer early has  not reduced the rate of later symptomatic breast cancer which suggests screening is not helpful.

This 10 minute video  explains the findings of this research in a clear and helpful way.

This is what researchers Bleyer and Welch concluded in their New England Journal of Medicine article:

“Despite substantial increases in the number of cases of early-stage breast cancer detected, screening mammography has only marginally reduced the rate at which women present with advanced cancer. Although it is not certain which women have been affected, the imbalance suggests that there is substantial overdiagnosis, accounting for nearly a third of all newly diagnosed breast cancers, and that screening is having, at best, only a small effect on the rate of death from breast cancer.”

Source:  Bleyer A & Welch HG. Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence.  N Engl J Med 2012; 367:1998-2005

• Bleyer A & Welch HG. Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence.  N Engl J Med 2012; 367:1998-2005.
• Gøtzsche PC.  Benefit and harms of mammography screening, and invitations to screening:  Written statement for the UK hearing on mammography screening, 8 March 2012.  This statement includes a summary of other studies on breast cancer screening.