THE DEBATE OVER MASS MAMMOGRAPHY - IS IT BENEFICIAL FOR WOMEN

The authors discuss the controversy about mass screening for breast ca ncer in order to assess the soundness of a nationwide expansion of suc h programmes. Mass screening is second best because of the failure of prevention, therapeutic progress or ability to target high risk popula tions, but its efficacy reducing mortality is not clearly demonstrated and the chances of one woman bring saved from participating are very low. Detrimental side-effects such as anxiety, false alarms, unnecessa ry biopsies, overdiagnosis and overtreatment and deficiency of psychol ogical approach are reported. On the other hand, mass screening may sa ve lives and if no recent study can provide absolute proof of efficacy , efficacy of systematic mammography cannot be proven either, even con cerning 40-49 years old women. Moreover, screening trials have allowed an improvement in medical practice, especially concerning quality and dose in mammography and radiographer's performance. Many questions re main unanswered about mass screening for breast cancer and the best wa y to achieve it. (C) 1997 Elsevier Science Ireland Ltd.