Breast cancer screening saves lives, but at what cost?

Breast-cancer screening saves lives even though it also picks up cases in some women that would never have caused them a problem, according to a review published in The Lancet. Critics of routine screening argue that women can be subjected to unnecessary surgery, radiotherapy and medication to treat cancers that would have posed them no risk. The researchers acknowledged the shortcomings of screening but argued that until testing for breast cancer becomes more sophisticated, regular monitoring is the best option.

Screening prevents about 1,300 deaths per year in Britain but can also lead to about 4,000 women having treatment for a condition that would never have troubled them. This means that for every death that is prevented, three women are over-diagnosed.

Research is under way that could lead to more sophisticated tests that distinguish aggressive cancers from those that are not. This, coupled with a better understanding of genetic predisposition and lifestyle factors that play a role in breast cancer, could mean more finely targeted screening and less over-diagnosis.