The breast cancer screening scandal has come as a shock to the public and rightly so. Yet the medical community has been almost unequivocally more circumspect.
What we know quite clearly is that a group of women – perhaps as many at 450,000 – missed their final mammogram tests in the older age bracket, which would be around the age of 70. The effect?
Well, as personal testimonials have shown starkly, some of those women later developed cancer.
The IT supplier embroiled in a row over breast cancer screening row has denied that its software was to blame for failures which may have seen 270 people die early
With statistical modelling it is possible to predict how many cases may have been missed because of the error. Many reports claimed that there may have been 270 deaths as a result of the IT blunder. This isn’t true.
The official line is that a maximum of 270 women may have had their lives shortened. This is very different to missed screenings being responsible for deaths.
The reason we have screening is so that more cases are spotted and treated, giving women the best possible outcome.
But it is impossible to know whether or not those missed cancers would have been curable if detected and therefore if deaths could have been prevented. Early detection doesn’t always mean significantly more lives saved: this is a clear fact from analysing screening data.
Of course, even one preventable death is too many. And I believe that every eligible woman should go to their mammogram appointment when invited.
But even with immense scrutiny of the screening detection rates and cancer diagnoses, we really cannot truly say what the effect is of missing this screening – particularly because it is the final one.
Screening of more elderly women is known to be less effective at picking up cancers than screening of those in their 50s. A scan in your 70s may not pick up all cancers and it often picks up false positives, more so than in the younger age groups.
For the older women who are offered catch-up screening now I would urge caution: treating women in their late 70s for small, early-stage breast cancers may do more harm than good – there is known to be over-diagnosis and over treatment in this age group.
Hitachi Consulting, based in Dallas (office pictured), has had a contract to run the software for the NHS’s breast cancer screening programme since 2015
So if you are a woman in this age group and you’re fit and well, but given the news that you missed the test, a catch-up screening may not be the best way forward.
Breast screening at this stage may well pick up something that would have been of no consequence to you, for example a slow-growing, non-aggressive tumour that would not be life-limiting.
Yet if this is detected, you would be offered intrusive treatment such as surgery that may significantly affect the quality – and even length – of your life.
The national breast cancer screening programme remains a good tool to detect cancer early but there are pitfalls to the programme, outside of computer glitches.
It is believed that for every life saved by breast screening, three women have surgery that turns out to be unnecessary.