Observations Breast Cancer Screening

The NHS breast screening programme needs independent review

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d6894 (Published 25 October 2011) Cite this as: BMJ 2011;343:d6894
  1. Susan Bewley, professor of complex obstetrics, Division of Women’s Health, King’s College London
  1. susan.bewley{at}kcl.ac.uk

The BMJ has published several articles over the past few years raising concerns about the accuracy and transparency of information provided to women about the benefits and harms of mammography screening for breast cancer (BMJ 2006;332:538, doi:10.1136/bmj.332.7540.538; 2009;338:b86, doi:10.1136/bmj.b86; 2010;340:c3106, doi:10.1136/bmj.c3106). Last month the professor of complex obstetrics Susan Bewley sent us for publication an open letter to England’s cancer tsar. Here we publish the letter and Mike Richards’s response (BMJ 2011;343:d6843, doi:10.1136/bmj.d6843)

Dear Mike

Personal reasons propelled me into the debate on breast cancer screening. As a house officer (in the early 1980s) working for two surgeons—one still performing “frozen section, query proceed to radical (Halsted) mastectomy” and the other promulgating the perceived heretical practice of breast conservation by lumpectomy—we dealt with what seemed an inevitably fatal disease. After my sister’s discovery in 2006 of a malignant lump when in her mid-40s I was impressed by the intervening improvements in diagnosis, treatment, care, and prognosis, which were based on a continuing programme of research evidence.

Approaching 50, with a family history of the cancer (grandmother, aunt, and sister) and risk factors (late childbearing, low parity, obesity), I had to consider …

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