Editorials

Breast cancer screening

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5625 (Published 06 December 2017) Cite this as: BMJ 2017;359:j5625

Re: Breast cancer screening

False positive breast cancer results after 10 years of mammography screening range from 33%-50% of women. [1][2][3][4][5][8][9]
All consequent overdiagnosis anxiety, depression, suicides, attempted suicides, risky behaviours, injuries, biopsies, mastectomies, irradiation, chemotherapies, lymphadenectomies, morbidity, mortality should be considered as iatrogenic, and calculated in National medical error statistics.
Thus, up to 50% of the population of mammographically screened women can be jeopardized by medical errors.
Nipple secretion cytology tests and targeted endoscopic biopsies are also used for breast cancer screening.
Even attempting to obtain combinations of first and second opinion on breast cancer pathology slides from expert pathologists with a high volume of diagnostic work, results in mistakes in 10.9% to 18.0% of patients. [6]
In a recent analysis of all available studies, cancer screening has never been shown to “save lives”. [7]
Conclusions of the recent Swiss Medical Board report for abolishing mammographic screening [10] agree with Professor Mette Kalager's conclusions.
Unfortunately, women still tolerate errors during breast screening.
A series of lawsuits and multi-million dollar compensation claims for harms induced will speed things up towards the right direction.
References
[1] http://www.cochrane.org/CD001877/BREASTCA_screening-for-breast-cancer-wi...
[2] http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61216-1/fulltext
[3] http://www.bmj.com/content/339/bmj.b2587
[4] http://www.cancer.gov/types/breast/hp/breast-screening-pdq
[5] https://www.youtube.com/watch?v=8A9xuLmUHcQ
[6] http://www.bmj.com/content/353/bmj.i3069
[7] http://www.bmj.com/content/352/bmj.h6080
[8] http://jamanetwork.com/journals/jama/fullarticle/2040228
[9] http://annals.org/aim/article/2596394/breast-cancer-screening-denmark-co...
[10] http://www.nejm.org/doi/full/10.1056/NEJMp1401875

Competing interests: No competing interests

07 December 2017
Stavros Saripanidis
Consultant in Obstetrics and Gynaecology
Thessaloniki, Hellas