If you are a woman between 40 and 44 years old, should you attend an organised mammography screening programme?
What should you know?
Background
Breast cancer is the second most common cancer in the world and, by far, the most frequent cancer among women.
The probability of a European woman developing breast cancer over her lifetime is approximately 1 in 8*. A woman's individual risk of breast cancer may be higher or lower than this average, depending on a number of factors, including age, family history, reproductive history (such as menstrual and childbearing history), race/ethnicity, and others.
Many countries have organised programmes for women aged 50 or older. However, there continues to be debate about recommendations for mammography screening particularly for women aged 40 to 49.
*This estimate is not intended for determining individual risk as it is only a measure of the average lifetime risk of developing breast cancer within the female population within each country (CI5 2014).
Problem
Mammography screening is a test that can detect cancer early on, but at the same time there are some risks associated with this test:
There is a risk of a false positive test result (a situation in which the test result indicates cancer is present when in reality it is not). This means that you would have further tests after the screening, which will confirm that you do not have cancer, but you may have suffered unnecessary anxiety and distress.
Also there is a risk of overdiagnosed cancer, that is a cancer diagnosed by screening which is so slow-growing that it would never have been diagnosed in a person’s lifetime if the person had not been screened. Treatment in that case is the same as if it was not overdiagnosed (possibly including mastectomy - breast removal).
Test
Mammography is specialised medical imaging that uses a low-dose x-ray system to see inside the breasts. A mammography test enables the early detection of breast cancer. Some women experience pain and discomfort during mammography.
Topics that you should discuss with your Health Care Provider
It will be important to speak with your healthcare professional to determine if you are at high, average, or low risk of breast cancer.
You can also speak with your healthcare professional about how you feel about the balance of benefits and harms, especially:
- Overdiagnosis leading to overtreatment, including the possibility of having an unnecessary mastectomy
- Anxiety and distress
- How fearful you feel about breast cancer
- How able you are to live with uncertainty
Explanation of outcomes used in process:
False-Positive Screening Result
Over-Diagnosis and Over-Treatment
Needle Core Biopsy
Mastectomy
Breast Cancer Stage
Pain and discomfort related to mammography
Assess your values
To calculate an individual recommendation and to help understand how good or bad a health state is we have created the scales below with "dead" marked as 0 and "good health" marked as 100. We would like you to indicate on these scales how good or bad each health state is in your opinion:
In my opinion my current health state is equivalent to:
0
Dead
50
100
Good Health
50
In my opinion having a needle core biopsy is equivalent to:
0
Dead
50
100
Good Health
50
In my opinion having a mastectomy is equivalent to:
0
Dead
50
100
Good Health
50
In my opinion having breast cancer is equivalent to:
0
Dead
50
100
Good Health
50
In my opinion having pain and discomfort related to mammography is equivalent to:
0
Dead
50
100
Good Health
50