Breast Cancer Screening Essay

1788 Words Sep 12th, 2014 8 Pages
An analysis of the effectiveness of population-based screening for breast cancer.

Breast cancer is the leading cause of death due to cancer in women, with statistics from the USA showing that one in eight women will develop the disease.1 Studies in the UK show that 90% of women diagnosed in the early stages survive the disease, while this figure is only 15% if diagnosed at a later stage illustrating the importance of an effective screening programme to reduce mortality.2 In the following essay I will review various randomised control studies and cohort studies in order to establish how nationwide screening programmes best reduce mortality, looking at the targeted sector of the population and the methods in practice. I will also address
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It should also be stated that screening programmes only reduce mortality rates if followed up by treatment of any identified problems. Treatment could be in the form of surgery to remove tumours before they metastisize or by chemotherapy if metastasis is at an early stage.3

When analysing the program adopted for breast cancer screening the benefits are always weighed against the harm caused by the procedure. The most prominent of these is overdiagnosis. Overdiagnosis occurs when a mammogram finds “cancers and cases of DCIS (ductal carcinoma in situ) that will never cause symptoms or threaten a woman’s life”4 leading to unnecessary treatment that causes adverse effects to the individual involved such as cancer therapy.4 False- positives are another area of concern when assessing mammograms as this means cancerous tumors will be identified where they do not exist. This issue has further implications as unnecessary biopsies are done on patients where there are no cancerous tumors present. These issues have been largely resolved by additional testing such as an ultrasound of diagnostic mammogram, though these procedures incur a cost and time element that would otherwise have been avoided.4 An added consequence of false-positives is avoidable anxiety and physical discomfort. Contrary to the harmful effects presented above, another area of concern is false-negatives. False negatives occur in roughly 20% of mammograms, with the result of unidentified cancer developing

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