Madam, – I refer to Barbara Redmond’s letter (August 15th). expressing concern regarding overdiagnosis and mammography screening.
At a time when Ireland is poised to make significant gains in reducing its mortality rate for breast cancer – currently 15 percent higher than the European average – by finally having BreastCheck rolled out across the country by the end of this year, together with the establishment of eight specialist breast centres, women should not be put off breast screening.
Some breast cancers grow slowly, lie dormant or even regress, and treating women with these tumours could be described as “over-treatment”. However, it is currently impossible to tell which tumours are aggressive and which are less harmful, so doctors offer treatment to most women and most women will opt to have that treatment.
Mammography screening is recommended by international experts for women between the ages of 50 and 70. (Half of the annual breast cancer incidence occurs in this group and 36 per cent of the mortality.) Breast screening is very successful at detecting the early stages of the disease in this age group – before the woman herself would notice a sign – and thereby increasing the likelihood of treatment being more effective and less severe.
Far from discouraging women from attending screening, Europa Donna Ireland is calling for the immediate extension of BreastCheck to women of 65 and older. Arguably the cessation of our national screening programme in the middle of the peak risk age for women is giving a false message.
Given the volume of breast cancer scares and breakthroughs that women are subjected to, it is crucial that they are properly informed of the potential benefits and harms of breast screening. With the rate of medical advances in detection and treatment, improvements can and will continue to be made.
Europa Donna, will be addressing the current state of evidence-based best practice in relation to national population screening at its biennial pan-European conference in Stockholm in October. Until it is possible to accurately determine the progression of cancers found through mammograms, screening remains an effective option for detecting breast cancers as early as possible and saves lives. – Yours, etc,