Mammographic screening: is the benefit worth the risk?

Justification of medical exposures is a fundamental principle of radiation protection. This principle applies to mammographic screening, both for the screened population and at an individual level. The benefit of mammographic screening may be considered to be the number of cancers detected or lives saved by breast screening. The risk is the hypothetical number of fatal cancers induced by the use of ionising radiation in screening mammography. Benefit can be deduced from the cancer detection rate in the NHS Breast Screening Programme. The number of additional lives saved by the intervention of a screening programme may be deduced from knowledge of the change in tumour size, stage and nodal status (and hence prognosis) in women with screening detected breast cancers compared with symptomatic women before screening. Calculations of benefit risk ratios to the UK population have been performed. It is concluded that breast screening is justified in radiation protection terms.