Do breast cancer screenings help or hinder women?

For years now a deep disagreement has fractured the community of scientists and doctors that treat women with breast cancer.

One side argues that screening detects breast cancer earlier than it would otherwise show up and therefore saves lives.

The other side disputes the figures behind that claim and make another telling point: screening shows up a lot of breast cancers that are too small or too slow-growing ever to produce any symptoms or bother the patient. It's called over-diagnosis.

But doctors can't tell the difference between these cancers and others that might kill, so they all get treated. That means many women, who would otherwise lead lives untroubled by breast cancer, are treated unnecessarily. And that causes them psychological and physical side-effects.

The new report is from an independent group of experts who have not been involved in this sometimes acrimonious debate. It was set up by Professor Mike Richards, the NHS cancer czar, and Harpal Kumar, the boss of Cancer Research UK. They hoped it would settle the issue once and for all.

After fighting through a thicket of conflicting evidence and statistics, this panel has come up with some answers. To me, they look well-judged and well-framed.

They say screening does save lives - 1,300 a year. But it also produces 4,000 cases of over-diagnosis a year too.

They think screening should continue but no scientific review, however good, can balance those two factors and provide a hard and fast answer to the question "should I go for screening?"

That's a question only the individual women can answer. But they should, the review concludes, be given better information about the risks and benefits of screening, so their decisions can be made on a proper foundation of knowledge.

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