To screen or not to screen: the debate continues...

The purpose of screening for any disease is to pick up the disease at an earlier stage.  It is based on the premise that the earlier a disease is diagnosed, the better the outcome for the individual.  

There is little doubt that the earlier breast cancer is detected, the better the prognosis but many questions remained unanswered:

- How should women be screened for breast cancer? Mammographic screening is expensive and sometimes detects breast cancers that might not cause problems if left untreated.  ie, cancers may may over treated.  Conversely, not all cancers are picked up mammographically.  
Clinical breast screening has it limitations: small breast cancers may not be detected and young women's breasts are difficult to examine.
-Who should be screened?  There is general consensus that women who have a family history should have regular screening.  Many high income countries offer screening to women between the age of 50-70.  Some (the USA) start at the age of 40.
-How often should women be offered screening?  Some countries screen yearly (USA), some every two years (Scandanavia) and other every three years (UK).

At Christiaan Barnard Memorial Hospital, we have started a new project.  Women over the age of 40 who are admitted to the hospital are being offered a free breast examination if they haven't had some form of breast screening in the preceding year.  

Does it work?  We dont know.  To our knowledge, it is the first time a programme like this has been offered.  We are doing it as a pilot project.

if you were being admitted to hospital for a routine operation (eg a hip replacement) would you want a breast examination while you were in hospital?

Please let us have your thoughts.


  1. I believe that the hospital is doing the right thing. People often ignore tests, and often find themselves regretting it later on. If they can detect an early sign, I'm sure they'll save lots of lives.

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