Why reconsider the recommendation of breast cancer screening?

Abstract

The aim of this article was to discuss the recommendation of mammogram screening for breast cancer and its technical basis. The first part discusses criteria for the decision, which should be consistent with highquality scientific evidence. The second part discusses over-diagnosis (the greatest harm of screening) and its meaning in questioning the natural history of disease model. The third part summarizes studies on the efficacy, effectiveness, and harms of screening, showing that the latter (especially over-diagnosis and false-positives) are significant, shedding doubt on the balance between harms and benefits. In conclusion, the recommendation of mammogram screening at any age should be reconsidered by Brazilian health authorities.