The edition 2018 of the campaign pink October was completed a few days ago. It was an opportunity for all health organizations, as well as for the government, to remember the importance of breast cancer screening by mammography. The interest of this screening is borne by the public authorities and the Institut national du cancer (INCa), is being seriously questioned by the scientific community. For example, professor Laurent Lantieri has opened the debate on the relevance of this testing in a tweet express posted on 9 November.
The chairman of the INCA, published his notice in the Parisian and other published studies : mammographic mass detection is ineffective https://t.co/Z5Jar3fn0a
— Laurent Lantieri (@LaurentLantieri) November 9, 2018
This straightforward position is based on a number of scientific publications questioning the public policies of screening. At the end of the month of October, the Union of young general practitioners (SNJMG) denounced in a press release the inefficiency and even the danger, of this preventive approach to breast cancer. A Cochrane review compiles no less than 7 trials on 6,000 women aged 39 to 74 years, some with follow-up the screening program by mammography and others do not. The conclusions of this review are without appeal : the screening would not reduce mortality from breast cancer.
Overdiagnosis
At the present time, it is impossible to tell if a cancer detected during mammography will evolve towards a disease, or even death. In practice, for 2 000 women participating in a mammography screening over a period of 10 years, one death will be avoided. In consideration, of screening 10 women that would not have been diagnosed if they had not completed mammography will be unnecessarily processed and will undergo treatments sometimes heavy (surgery, chemotherapy and radiotherapy), which can themselves lead to death. Finally, about 2 000 women undergoing screening mammography, more than 200 will have a false-positive test results and will be subject to multiple reviews, resulting sometimes in the distress and anxiety.
another publication, published in the very serious British Medical Journal, analysis at the scale of the netherlands, the impact of screening between 1989 and 2012. The conclusion is without appeal, the authors argue that the Dutch programme of mammography screening seems to have little impact on the burden of advanced cancer of the breast, and would have only a marginal effect on mortality. Furthermore, the authors suggest that approximately one third of cancers that are detected on the screen would be neither more nor less than an over-diagnosis (cancers do not change and do not lead to mortality). These data corroborate those of the Cochrane review and question the persistence of a model of systematic screening institutional. The interest of screening by mammography should, therefore, raise even a few heated debates between the advocates of the medicine based on evidence (Evidence Based Medicine) and the public authorities, which do not seem to hear it of this ear.
in Addition to mammography, it is important to remember that screening for breast cancer going on also and primarily by palpation, palpation must be performed by a physician (general practitioner, gynecologist) or a midwife once a year at the age of 25 years. This consultation may be the opportunity to learn the techniques of self-examination and to carry out frequently between the specialist units. If you ever observe a change in the breast (the appearance of a ball, change the shape or color of the areola, modification of the nipple), promptly see your doctor (gp or gynaecologist) to launch the battery of examinations in a timely manner.
On the same subject, critics of breast cancer screening are being ” irresponsible “
