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Does the NHS’s breast screening programme do you more harm than good?

Some doctors in the UK are questioning the value of breast screening.

For some time, breast screening has been accepted as a major health benefit that can help save lives through early identification of cancerous cells. All women aged between 50 and 70 are offered a free mammogram every three years to detect early signs of cancer. The screening programme has been hailed as saving well over 1,000 deaths a year from the disease.

However, this highly efficient screening programme also picks up signs of a slow growing type of cancer, DCIS (ductal carcinoma in situ). Signs of this will be followed by further tests, possibly biopsies and even mastectomies, radiotherapy, chemotherapy and other strong cancer treatments.

Yet not all DCIS cases will be dangerous. DCIS is often known as a “pre-cancer” and determining which will go on to develop into an invasive cancer is at the moment very difficult.

Dr Trish Groves, deputy editor of the British Medical Journal, says that it is known that around 20 per cent of cases diagnosed by screening are DCIS, a very early form of breast cancer. This can only be picked up by mammogram and is very new. Little is known about how DCIS spreads and grows but initial research suggests around 50 per cent of this type of cell change will never spread and are not actually cancerous.

“Yet DCIS is treated the same way as all other breast cancers,” says Dr Groves. “Although some women may be happy to have a complete regime of treatment for a condition which may not be cancerous, most will not. Either way, we have to accept that screening means that a large number of women will undergo a life-changing, painful, nasty treatment regime when, in fact, there is nothing wrong with them at all.”

As the topic of mammograms for all older women heats up, more and more information is coming into the public domain.

CancerActive, a complementary cancer charity who are not in support of certain paths of modern medicine, report that of 2,000 women who are regularly screened for 10 years, one woman will benefit and avoid dying from breast cancer; 200 women will receive false positives and 10 women will unnecessarily be treated with surgery or major treatments. Researchers at Southampton University assessed this report and their findings, published in the British Medical Journal in December 2011, states that mammograms have caused net harm.

The NHS Annual Review of Breast Screening published in 2012 reported on the findings of an Independent Breast Screening Review panel. The panel concluded that the breast screening programme does offer significant benefit to women, preventing around 1,300 deaths from breast cancer every year in the UK.

However, it also noted that around 4,000 additional women are diagnosed with breast cancer each year, equating to three overdiagnosed cases for each breast cancer death prevented. This of course causes enormous emotional stress as well as the physical changes resulting from any surgery or medication.

At the beginning of May the Journal of the Royal Society of Medicine published a paper confirming that far from being a huge benefit to women, breast cancer screening may in fact be doing nearly as much harm as it does good.

The total number of women invited to breast screening has risen again to the latest figure of 2,862,370. Age groups are also being extended to include4 47 to 49 year olds and 71 to 73 year olds.

This means that more and more women will need to seriously consider their options if they are diagnosed with DCIS. The normal route into more tests and treatment may not in the future be accepted by everyone as a route they want to take at that time.

There is a great deal of information on the internet now about breast screening, and your own doctor will be able to give you individual advice.

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