ASO Author Reflections: Impact of Breast Cancer Screening Beyond Mortality Reductions

Excerpt

Population-based mammographic screening was introduced after trials showed a reduction in breast cancer mortality. Mortality benefits have been demonstrated in established screening programs; however, rates of precancerous lesions (especially DCIS) and early and localized cancer have increased with no change to rates of cancer involving regional nodes. This has led to concern that overdiagnosis may offset much of the benefit of early diagnosis, with some calls to halt population-based screening.1 A more refined evaluation of the benefits and harms of screening would consider modern treatment practices that combine adjuvant therapies and conservative surgery to minimise the burden of treatment, particularly for patients with early and localized disease, thus increasing the benefits of early diagnosis beyond reductions in breast cancer mortality. …