Mammography Screening – How Persistent Should we be in the Recommendations?

Abstract

55 year old women came to me as her family doctor, seeking advice on mammography screening. She rather wouldn't do it because she feels well, is a bit afraid of radiation and thinks it’s not important, since she doesn’t have individual risk. Having in mind newly emerging evidence about the questionable value of the screening, especially in women without any risks, I was in dilemma what to recommend. Therefore, we did a limited literature search. Systematic reviews are questioning effectiveness of mammography as screening method, evidences show limited effect on reducing mortality and the burden of overdiagnosis and overtreatmnent. Professional recommendations vary from country to country. Overall impression is that many questions remain open and, until better method of screening is found, the decisions about breast cancer screening should be strongly individualised, according to the patients risks. We openly discussed it, she decided to postpone mammography for a while.