Discussing the benefits and harms of screening mammography

Mammographic screening programs were established around the world following randomised clinical trials showing that women who were screened had a significant reduction in the risk of dying from breast cancer. Now, decades later, several harms of screening have become apparent and the degree of risk reduction is being debated. This article aims to provide clinicians with evidence-based information about the benefits and harms of screening mammography to enable them to confidently discuss the issues with their patients. The issues around screening for breast cancer in asymptomatic women at average risk are complex. Women need accurate, balanced information to make an informed decision about whether they wish to participate in screening. The decision will vary from one woman to another, depending on her level of anxiety about cancer and recall, her personal values and her philosophy about health care.