Breast screenings lack detail, study finds

BreastCheck, the national breast cancer screening programme, is not providing women with balanced information with which to make an informed choice about undergoing mammography, new research suggests.

Dr Patricia Fitzsimons, a Sligo-based breast radiologist, compared the information provided to women on the risks of overdiagnosis prior to screening in the UK, Canada, Australia and the US with that available here.

Overdiagnosis is where screening identifies a tumour which would have remained undetected for the rest of the woman’s life without causing illness if it had not been detected.

Dr Fitzsimons has found that women in Ireland are not given information on overdiagnosis compared with Canada, which clearly states what overdiagnosis is. She acknowledges that as a result of this, and false positive results, women may decide not to go for screening.

Significantly, screening programmes that use absolute statistics and inform women of the limitations of breast screening, have attendance rates approximately 10-15 per cent less than those that do not, Dr Fitzsimons said.

Asked if it would also be producing new material for women invited for mammography here, specifically including the use of absolute risk and an explanation of overdiagnosis, a BreastCheck spokeswoman said the issue would be considered by the BreastCheck executive management team and its quality assurance committee.

Dr Fitzsimons’s research coincides with an independent report in The Lancet which said that for every 10,000 UK women aged 50 undergoing screening for the next 20 years, 43 breast cancer deaths would be prevented and 129 cases of breast cancer, invasive and non-invasive, would be overdiagnosed.

“That is one breast cancer death prevented for about every three over-diagnosed cases identified and treated,” the panel concluded.