Organized breast screening: Answers to recurring controversies

Abstract

The reduction in mortality specifically from breast cancer, demonstrated in the major meta-analyses in the 1980s resulted in public health breast cancer screening programs being set up in many countries, including France. Recent publications have challenged the usefulness of screening, by insisting in particular on the negative effects of overdiagnosis and the lack of any significant impact on mortality. From analysis of the literature and particularly independent reviews published in 2012, we provide some answers for doctors faced with the legitimate concerns of women. These studies confirm that screening in the right age group reduces specific mortality by at least 20% at a cost of overdiagnosis estimated at between 1 and 15%.

Conservative Treatment of Breast Cancer and Oncoplasty at the Teaching Hospital Mother and Child of Jeanne Ebori Foundation in Libreville (Gabon)

“…In our study, as in most African series [3] [4] [5], this delay in consultation explains the discovery of the disease, for the most part, by autopalpation. In European series, however, BC can be detected in almost 40% of cases [12]. Delayed diagnosis of this disease contributes to delaying the widespread use of conservative treatment and oncoplasty, compared with Western series where the percentages easily reach 60% to 75% [13].…”

Le traitement conservateur du cancer du sein: expérience d’une équipe tunisienne

“…Une seule patiente a été diagnostiquée au stade infraclinique c′est-à-dire lors d'une mammographie systématique demandée en consultation. Alors que dans les séries européennes, le CS peut être dépisté dans prés des 40% des cas [ 7 ] . Ce ci s'explique pas l'absence à ce jour d'un programme de dépistage organisé du CS en Tunisie.…”

Screening Mammography

“…Radiologists in France conclude from the literature and ''particularly independent'' reviews published in 2012 that screening ''in the right age group'' reduces breast cancer-specific mortality by ''at least'' 20% at a cost of overdiagnosis they estimate to be between 1% and 15% (22).…”