Journal
RADIOLOGIC CLINICS OF NORTH AMERICA
Volume 59, Issue 1, Pages 19-27Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.rcl.2020.09.005
Keywords
Overdiagnosis; Screening; Mammography; Breast cancer; Risks; Harms
Funding
- General Electric Healthcare
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Screening mammography, while imperfect, remains the best tool for early detection of breast cancer with significant mortality reduction benefits. The risks of overdiagnosis and underdiagnosis need to be balanced, with underdiagnosis posing a greater health risk to women. Continued research is needed to improve the specificity and reduce the risks of breast cancer screening.
In conclusion, screening mammography is an imperfect examination, but is currently the best tool available for the early detection of breast cancer when treatment options and survival are more favorable. The important mortality benefit offered by screening participation should not be eclipsed by its risks. Duffy and colleagues43 reported a 30% mortality reduction with screening in the UK, and concluded that 2 to 2.5 lives were saved for every case that was estimated to have been overdiagnosed. At this time, the potential underdiagnosis of breast cancer without screening poses a more severe health risk to women than overdiagnosis. As understanding of breast cancer progression and tailored treatments continues to evolve, overtreatment of certain nonharmful breast cancers will decrease. Work should continue on methods to mitigate the risks of breast cancer screening to improve specificity and reduce radiation exposure.
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