Controversies regarding mammography, breast self-examination, and clinical breast examination

The number of women diagnosed with breast cancer continues to increase, but mortality rates have substantially declined. Much of the credit for this decline has been attributed to early detection from mammographic screening. However, there are significant controversies about the effectiveness of all screening tools for breast cancer, concerns about the potential harm that can result from screening, and questions about the appropriateness of screening recommendations. One of the greatest barriers to achieving consensus is the lack of agreement about the purpose of screening efforts. This article reviews many of the current controversies and attempts to clarify the arguments.