Authors' objectives:

To summarise the available evidence on the use of mammography in mass screening for breast cancer.

Authors' recommendations: The available evidence regarding the efficacy of breast cancer screening by means of periodic mammography in women of 50 years of age or more, is solid and consistent, and is based fundamentally on the results of randomized intervention trials carried out in Canada, the United States, and Europe. At present, there is no available evidence that screening with mammography, using the proposed techniques and frequency for women of 50 years of age or over, can reduce breast cancer mortality in women of 40 to 49 years of age. Although we do not have direct evidence, we can not exclude the possibility that other more frequent screening modalities may have some effect on the mortality rate in younger women. The interval between tests is a decisive determinant in the cost-effectiveness of breast cancer screening programmes. The additional benefits of changing from a system of mammography every 2 years to a 1 year interval are considered low, while the additional associated costs on attaining these benefits are rather high. Among the most frequent relevant adverse consequences of screening with mammography are the carrying out of excessive biopsies and other unnecessary diagnostic tests, and the need to return for additional or repeat views. High-quality mammography is considered an indispensable requisite for a screening programme to be able to reach the objective of a reduction in breast cancer mortality while minimizing the adverse consequences of the massive application of this technique. Assuring high participation in the screening programmes is a necessary condition for achieving a reduction in the mortality rate for breast cancer in the general population.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.isciii.es/aets

Year Published: 1995

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias

Contact Address: Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;

Contact Name: Luis M. Sánchez Gómez

Contact Email: luism.sanchez@isciii.es

Copyright: Agencia de Evaluacion de Tecnologias Sanitarias (AETS)