[Screening of cancer of the breast]

Breast cancer is the commonest cancer in women. Screening for a severe and frequent disease with a long doubling time can be applied to breast cancer. Mammography is accepted by the population as a screening test, as it is simple, painless and safe. Many foreign studies combining either clinical examination and mammography or using mammography alone have confirmed the following elements: cancers are detected at an earlier stage than in the control population, screening of women under the age of 50 years does not provide convincing results, as a decreased mortality is only observed for women over the age of 50 years. Screening was introduced in France in 1989 by law and is now performed in 8 departments. The number of deaths prevented as a result of this action is estimated to be a minimum of 1,000 per year. Screening has positive effects on the quality of radiological equipment, improvement of preoperative detection techniques and on the accuracy of the pathology report. Inversely, its disadvantages include false-negative and false-positive results, leading to a certain number of negative operations. Screening will decrease the incidence of invasive cancers and mastectomies and the role of reconstructive surgery after mastectomy for breast cancer. However, the indications for plastic surgery in clinically detectable breast cancer will increase based on collaboration between breast cancer specialists and plastic surgeons.