Breast screening for the over-70s does more harm than good. It doesn’t prevent deaths from breast cancer, but it does initiate over-diagnosis and over-treatment-and a great deal of unnecessary worry, a new research paper has concluded.
Routine mammography breast cancer was extended to women aged between 69 and 75 in 1998 in the Netherlands, and Dutch national guidelines now recommend screening for all women up to the age of 75.
But is the new strategy doing any good? Researchers from Leiden University Medical Centre analysed data from the women screened from 1995 to 2011 who fell into the older age group, and then compared them with women aged 75 and older, and who were exempt from screening.
They discovered that for every case of early advanced cancer that was detected, 20 ‘false-positives-or cancers that were wrongly detected-were also identified. Despite the wrong diagnosis, the woman invariably endured months of unnecessary treatment, which may have included chemotherapy and even mastectomy, or breast removal.
A more sensible approach is needed, say the researchers. Instead of a blanket screening programme for the older woman, doctors need to individually select those women, based on breast cancer risk profile and life expectancy.
(Source: British Medical Journal, 2014; 349: g5410)
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