Independent UK Panel on Breast Cancer Screening concluded in a review published yesterday in Lancet that every 3rd year screening from 50-70yo decreased breast cancer mortality but also increased overdiagnosis, similar to conclusions from the other side of the pond. In fact, for every 10,000 50yo British women screened for 2 decades, mammography would prevent 43 breast cancer deaths while 129 cases of breast cancer would be overdiagnosed. By overdiagnosis, we conclude that it's unlikely that cancer would've led to that person's demise. In other words, for every death prevented, 3 women were treated who would never have needed treatment and thus needlessly suffered from the side effects of treatment.
Am I anti-mammogram? Of course not! Just like I'm not anti-PSA either. Instead, rather than paint with a broad brush, we need to start wielding a very fine paintbrush and personalize testing & treatment options to the individual. So don't blindly order a mammogram but rather have a conversation with your patient and discuss both the benefits and the potential negative consequences, too.