Benefits and Risks of Breast Cancer Screening

Breast cancer is not a singular illness, but comprises a very heterogeneous group of various subtumours with differing prognoses. In general, the survival rate is dependent on specific prognostic factors. These include tumour size, axillary lymph node metastases, distant metastases (TNM classification) and histological differentiation grade. Hypothetically, it should be possible to favourably influence these prognostic surrogate parameters with effective screening interventions. Furthermore, changes in tumour stages and prognostic factors have had a considerable impact on locoregional and systemic therapies, which also might be one reason for an association between certain trends and screening interventions. Recently published studies have impressively demonstrated these effects: As early as 2003, a screening mammography programme was commenced in Bavaria, which was turned over to the national screening programme in 2006. On a total of 75,575 registered breast cancer cases (primary diagnosis 2000–2008) in this Bavarian cohort, an initial analysis of the trends in prognostic factors and standard therapies for the 3 age groups (up to 49 years, 50–69 years, >70 years) was conducted based on annual percentages and 95% confidence intervals (CI) for the percent difference between the year of Breast Cancer Screening: Pro Achim Wöckel (Würzburg); Wolfgang Janni (Ulm)