Breast Screening Debate
Chief Executive Chris Askew responds with a firm 'yes' to the question posed in Guardian G2 whether women should attend their breast screening appointments.
09 Aug
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Luisa Dillner writes “while screening may catch [breast cancer] early, there’s no guarantee” (Dr Dillner’s health dilemmas: should I be screened for breast cancer?, G2, 1 August). Breakthrough Breast Cancer hopes this will not discourage women from attending breast screening appointments. One in eight women will develop breast cancer and screening aims to detect the disease at the earliest possible stages.
The number of deaths from breast cancer is falling due to earlier diagnosis and better treatment - the exact number of lives saved will continue to be debated. Dr Dillner herself quoted two separate figures, which show that lives are saved, regardless of whether it is 1,347 or 500 a year.
A particularly important aspect of breast screening is that it can detect breast cancer at the earliest possible stages when no other symptoms are obvious – and the earlier breast cancer is diagnosed, the better, as treatment are more likely to be less aggressive and have successful outcomes.
Dr Dillner is right to highlight that “not all diseases progress”. Breast screening can detect a non-invasive form of breast cancer called ductal carcinoma in situ (DCIS). What Dr Dillner doesn’t highlight is that it is very difficult to predict which of these cancers will develop into life-threatening disease and which will not – so treatment will be offered. Many women welcome this intervention.
The choice to attend screening can only be made by the individual and women are encouraged to read the information leaflet which accompanies all invitations for screening. It is extremely important that women are given clear, balanced, good-quality information about the benefits and risks of screening to enable them to make informed decisions.
The latest BMJ paper does not tip the balance in favour of abolishing breast screening. It is important that the evidence for and against screening is continually reviewed and consideration given to how screening can be best targeted. However, for now, let’s focus on ensuring we have the best possible screening service and that women are provided with the information they need, so we can continue to detect this disease earlier and treat it effectively.
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