A study published in today's British Medical Journal shows a reduction in mastectomy rates following the introduction of a breast screening programme. The study counters recent suggestions that screening for breast cancer increases the number of mastectomies.
The analysis of the screening programme in Florence, Italy, looked at changes in the rates of radical and breast conserving surgery since the screening was introduced. Between 1990 and 1996 almost 60,000 women aged 50-69 years were invited to participate in the programme. It found that for every 1,000 women in the population the rate of breast conserving surgery increased significantly from 1.18 in 1990 to 1.87 in 1996.
During the same period, the rate of radical surgery (mastectomy, complete surgical removal of the breast) had almost halved. Women diagnosed with an early stage breast cancer were more likely to have breast conserving surgery - the removal of a lump or part of the breast only.
The results contrast with a recent controversial review by the Cochrane Library which suggested that screening increased the number of mastectomies by around 20 per cent, mainly as a result of over diagnosis. However, the authors of the Italian research said their findings indicated that the introduction of breast screening brought about a reduction in the number of mastectomies for breast cancer and an increase in the rate of breast conserving surgery.