Breast cancer screening: a different look at the evidence.

The data on screening for breast cancer were studied to extract information on rates of biopsy recommendation, detection of benign disease, and mortality. Relative and absolute mortality rates for breast cancer and other causes were calculated. Approximately 5% of women screened have a suspicious result and are referred for further assessment. The reduction in breast cancer mortality rates attributed to screening procedures ranges from 0.049% to 0.144% of the screened population, demonstrating that up to 2041 women must be screened for each woman who will benefit. If women subjected to operation for benign disease are considered to be harmed by the screening program, then the harm/benefit ratio ranges up to 62:1. It is suggested that enough information on the question of cost/harm/benefit is already available to make the decision that mass screening for breast cancer should be abandoned and that the procedure should be reserved for those women with high-risk factors.