Breast Cancer Screening

Screening and early detection to achieve better disease control has been a major area of research as incidence is increasing gradually. Breast self-examination, clinical breast examination and mammography have been considered the modes of breast cancer screening. Kerlikowske et al. in 1995 performed a meta-analysis of 13 studies and found that the overall relative risk (RR) estimate for breast cancer mortality for women aged 50–74 years undergoing screening mammography compared with those who did not was 0.74 (95% confidence interval [CI], 0.66–0.83). They also reported that the benefit was similar regardless of the number of mammographic views per screen, screening interval or duration of follow-up. However, RR estimates for women aged 40–49 years were not less than 1.0 [1]. Interestingly, another meta-analysis of eight randomized controlled trials of screening mammography involving women aged 40–49 at entry reported a statistically significant 18% mortality reduction among women invited to screening mammography [2]. With the introduction of the screening programme, Archie Bleyer et al. (2012) reported a doubling in the number of cases of early-stage breast cancer with an absolute increase of 122 cases per 100,000 women and women present with late-stage cancer had decreased by 8%. However, the authors highlighted nearly 31% overdiagnosis in the same period [3].