Abstract
Overdiagnosis and breast cancer screening
Highlights
Screening for breast cancer is routinely performed in most countries where the disease is common
Usually the most malignant, will be fast growing and less amenable to the benefits of earlier detection, in the context of periodic testing in a mass screening programme; others, often the more benign, will be slow growing and probably successfully treatable whenever diagnosed. Among these slower-growing tumours will be a proportion that were never destined to surface as clinically apparent cancers in the lifetime of the individual. The effect of this heterogeneity has been seen clearly in the early randomised trials of screening for lung cancer, in which despite an increase in the number of early cancers diagnosed on the screened arm of the trial, no reduction in lung cancer mortality rates was seen among those randomised to screening
Lesions that are detected at screening but which would not have surfaced clinically in the lifetime of the individual constitute overdiagnosis, the major form of harm associated with screening programmes
Summary
Screening for breast cancer is routinely performed in most countries where the disease is common. See related review by Moss in this issue [http://breast-cancer-research.com/content/7/5/230] Breast Cancer Research has invited a series of papers to address the component dimensions of the field, and in particular to estimate the extent to which it occurs.
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