Breast cancer screening recommendations: is mammography the only answer?

Abstract

Early detection of breast cancer is important to reduce mortality and morbidity. Traditionally, three methods of breast screening were recommended: mammography, clinical breast examination (CBE), and breast self-examination (BSE). At present, BSE and CBE are no longer widely recommended, while mammography is still broadly promoted in the Western world. The primary intent of this article is to examine whether current health policy recommendations related to breast cancer screening are informed by evidence. The issue of whether women are adequately aware of the potential benefits and risks of breast screening methods to make informed decisions is also discussed. It is argued that it is premature to caution women against BSE and CBE because the current evidence is inconclusive or incomplete. Moreover, women should be better informed about the potential harms associated with mammography screening. Recommendations for research and health policy are also discussed.