Scientists continue to argue about the benefits of breast screening, but ultimately decisions about screening should be made by women themselves. To make this decision, however, women need to fully understand both the benefits and the potential harms

Although mammographic screening is well established in the United Kingdom and elsewhere, its value continues to be debated. Most of the data on mammographic screening come from a group of clinical trials completed over a decade ago. These are subject to constant reworking, reanalyses, and wrangling between the screening zealots and the screening sceptics. New data are unlikely to emerge, as it is improbable that new screening trials, with a control group that is “left to nature” will be conducted.

Decisions about mammographic screening should be based on all the facts

Credit: CHRIS PRIEST/SPL

Most of the controversy surrounding screening, however, seems to miss the point. The question of whether the benefits of screening outweigh the harms is essentially a value judgment. The problem is that, up to now, this judgment has been made by paternalistic agents of the state rather than by women, supported by their general practitioners or others. In order to make an informed choice on screening, women need to be aware of the range of uncertainties for both the benefits (that is, preventing death from breast cancer) and the harms.