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 …