BMJ 2002;325:418 ( 24 August )

Papers

Are breast cancer screening programmes increasing rates of mastectomy? Observational study

Eugenio Paci, director ^a, Stephen W Duffy, principal scientist ^c, Daniela Giorgi, senior epidemiologist ^d, Marco Zappa, senior epidemiologist ^a, Emanuele Crocetti, senior epidemiologist ^a, Vania Vezzosi, pathologist ^e, Simonetta Bianchi, senior pathologist ^e, Luigi Cataliotti, professor of surgery ^f, Marco Rosselli del Turco, director ^b. 

^a Unit of Epidemiology, Centre for the Study and Prevention of Cancer CSPO, Via di S Salvi 12, 50135 Florence, Italy, ^b Screening Unit, Centre for the Study and Prevention of Cancer CSPO, ^c Dept of Mathematics, Statistics and Epidemiology, Imperial Cancer Research Fund, London WC2A 3PX, ^d Unit of Epidemiology, Azienda Sanitaria Locale (ASL) 2, 55100 Lucca, Italy, ^e Pathology Department, University of Florence, 50134 Florence, Italy, ^f Surgery Department, University of Florence

Correspondence to: E Paci Epid1@cspo.it

The first 150 words of the full text of this article appear below.

In the recent Cochrane review of mammographic screening the authors and editors disagreed with respect to reporting the effect of screening on rates of aggressive treatment for breast cancer.¹ The authors maintained that screening increased the number of mastectomies by around 20%, mainly as a result of overdiagnosis. If this were the case, populations in which screening has been introduced should see a subsequent increase in the number of radical treatments for breast cancer and an increase in the incidence of breast cancer in excess of that expected purely from lead time. We report the changes in rates of radical surgery and incidence of breast cancer since the introduction of the Florence mammographic screening programme.

	Methods and results

We studied the period from 1990 to 1996. During this time 59 947 women aged 50-69 years were invited to a prevalence screen and to subsequent screens at two year intervals (2.4 years in practice).² At the beginning of 1990 no . . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

Inappropriate use of evidence?

Hazel Thornton
bmj.com, 24 Aug 2002 [Full text]

Screening and Mastectomy rates

Michael Baum
bmj.com, 25 Aug 2002 [Full text]

Misleading paper on mastectomy rates in a screening programme

Peter C Gøtzsche
bmj.com, 27 Aug 2002 [Full text]

Confounding Factor

Des Spence
bmj.com, 27 Aug 2002 [Full text]

Are breast cancer screenig programmes increasing rates of mastectomy?

Robert Hall
bmj.com, 29 Aug 2002 [Full text]

Study internally invalid

Richard H Moore
bmj.com, 1 Sep 2002 [Full text]

Re: Botticelli's "birth of Venus"

Eugenio Paci, et al.
bmj.com, 24 Oct 2002 [Full text]

Incomplete data and wrong conclusion: what happened to 70% of women diagnosed in 1996?

Jayant S Vaidya
bmj.com, 16 Jul 2005 [Full text]

Re: Incomplete data and wrong conclusion: what happened to 70% of women diagnosed in 1996?

Jayant S Vaidya
bmj.com, 28 Jan 2006 [Full text]

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