France Considers Terminating Breast Screening Programme

An independent review of breast screening in France has prompted officials to consider terminating the programme.  France is the most recent European country to consider putting an end to breast screening.

Two main findings continue to surface each time a country conducts an extensive review of the evidence.  The first finding is that there is a lack of reliable evidence to support the claim that breast screening can save lives.  The second finding focuses on the harms caused by breast screening; the incidence of overdiagnosis that can lead to unnecessary and harmful interventions.

These findings are compelling and are spearheading changes to breast cancer screening programmes.

In 2014 Switzerland concluded that “no new systematic mammography screening programs be introduced, and that a time limit should be placed on existing programs.”  The Swiss medical board’s expert panel examined evidence that included the finding that the benefits of screening do not outweigh the harms:

  •  one of the largest and longest study on mammography screening concluded  mammograms have absolutely NO impact on breast cancer mortality
  • 22% of the women in the study were over diagnosed and underwent unnecessary interventions, which included needless surgery, radiotherapy, chemotherapy, or some combination of these

In Denmark a large cohort study examined tumor size and overdiagnosis.  The study concluded that breast cancer screening was NOT associated with a reduction in the incidence of advanced cancer and also that it was “likely that 1 in every 3 invasive tumors and cases of DCIS diagnosed in women offered screening represent overdiagnosis”.

In 2017 France published an article that outlines proposed changes to the breast screening programme.  Following a review of the evidence, french officials found that there was a great deal of uncertainty about the benefits of screening.  They also found that “breast screening leads to substantial overdiagnosis, and that patient information on breast screening should be more transparent and neutral”.

There is no reliable evidence to support the claim that mammography screening saves lives, but there is clear evidence that mammography screening can cause harm.

Thanks Adawells for providing the original link and information for this post https://forwomenseyesonly.com/2017/10/27/unnecessary-pap-smears-discussion-forum/

References/Sources:
http://cyrcadiahealth.com/why-mammography-screening-is-being-abolished-in-switzerland/
https://www.nejm.org/doi/full/10.1056/NEJMp1401875
https://www.bmj.com/content/350/bmj.h139/rapid-responses
http://annals.org/aim/article-abstract/2596394/breast-cancer-screening-denmark-cohort-study-tumor-size-overdiagnosis
http://nordic.cochrane.org/news/france-proposes-radical-changes-their-national-breast-screening-programme-based-cochrane

53 comments

  1. Good on France and all the sensible Northern European countries!
    Meanwhile here in Australia we are made “aware”, pressured and urged to present our boobs for crushing and radiation as often as the medical bureaucrats of the day see profitable. Any person with at least one brain cell will see that the pitch in the breast-screen propaganda brochures is flawed and the numbers regarding cancer incidence and “saved lives” do not add up epically, yet there are still enough gullible women to keep the tit-butchery business going.

    • Yes that is so true. It astonishes me that women I know who have advanced degrees and hold high-level professional jobs don’t see the ruse and keep going for their mammograms, which are generally recommended to start at age 40 here in the US. It’s immensely frustrating and trying to get them to see the real deal with this barbaric test is futile. It is heartening that some countries and individual women are wising up.

      • I started questioning all when a woman who was slightly older than I (mid 40’s) got a mammogram and the diagnosis of DCIS. She was given a double masectomy and a botched reconstruction. She almost died of the infection after the surgery. She NEVER had cancer. She lost her breasts and almost her life for WHAT?

      • Judy, both my sister and SIL totally believe in it all and both have university degrees. In the brief times we’ve discussed this I’ve been brushed aside as if I don’t know what I’m talking about.
        I find there is a lot of research into why women don’t take up screening – all of it starting from the pre-formed conclusion that screening saves lives and is faultless and always designed to increase uptake. The conclusions they always draw are that women who don’t go are afraid to, because they are too afraid of what the result might be, too afraid of cancer, too afraid of making a decision, or too afraid to act to attend screening. There is never any research into why women become sheep and roll up to all this crap screening. My answer would be that, like the women in the research, they are too afraid to say no, too afraid to stand alone, too afraid to question the dogma, and too afraid to have the safety net taken away, and have a life free from screening. It works both ways. In both cases people are afraid of being proved wrong and afraid of confronting a situation they would rather not believe in. They would rather just carry on as before.

  2. It will indeed be a long time before Australia admits the harm of mammograms. Too many institutions and individuals are making money on squishing and radiating breasts of naive women or running the “awareness” bullshit.

    It is the same story as with the harmful pap smears: it’s been known for a good decade that pap smear screening harmed more women than saved, but the so-called “health care” system was delaying and procrastinating with ditching the programme, because the main concern of the system was the employment of the army of pap smear scrapers, cervix butchers and pathology laboratory minions. The system grew and bloated to the point where it took over 5 years to find new income source for its displaced demons. Only then, once it figured out how to keep the control over women and the profits with the new HPV testing, it declared its support for the change.

  3. The funding for these women’s health issues is highly political. So reading articles like these makes me upset. I would rather the money was used for other issues affecting women such as affordable housing, safe daycare, prevention of family violence and programmes to stop all the community violence. I can’t go a day without switching on the news and hearing about so,e shooting or stabbing in the city.

    • I don’t know how I keep missing all this stuff, so great to have some of you keeping us informed. This all seems a bit strange to me. What’s with this 70% of us are at higher risk of cancer and only 30% are at low risk? I’d always found the actual risk figures to be 1/2000 at age 30 to 1/9 at age 85 and above. Even taking the figure for the over 85s, it’s nowhere near the 70% risk they are quoting for every woman of any age. Funny how they’ve noticed that numbers currently actually turning up are 72%, almost matching their 70% at high risk figure. Is this another attempt to keep women into screening? The only reason they extended the screening age was to bring in an extra 6 million women, to boost the uptake to over 70%. I’ve never forgotten reading some time ago that these programmes are not economically viable if less than 70% attend. It seems to me that this is another ploy to keep women going for screening. Will have to wait until the autumn to see what happens. This is the first I’ve heard of anything like this being implemented so soon.
      Similarly, we have still not heard about our cervical screening programme changing, apart from the Daily Fail article posted by Kat. They are keeping very quiet about it. Perhaps they leaked the story to the Daily Fail to test the reaction to switching to HPV testing. From looking at one of Margaret McCartney’s old posts, she says that GPs have been notified for some time if a smear test result contains HPV, and also that GP is supposed to advise the woman if it does, so this testing has already been going on unannounced for some time. I don’t think they are telling any of us in the UK what is going on. Keeping the herd in the dark as usual.

  4. Unfortunately, I can’t reply to Moo’s comment above about DCIS, but I think I may have had it years ago. Had discharge from the nipple, a milky substance that would occasionally turn muddy or even dark, and eventually a scaly red rash on the areola. Eventually it cleared up, first the rash then the discharge, and I haven’t had a problem since. Been ten years since it stopped, feeling fine. I looked up DCIS symptoms after reading The Patient Paradox and holy crap, those were the symptoms! My family harassed me to get checked out, and now they’re glad I didnt, after hearing what I might have been put through for absolutely nothing. My doctor, on the rare occasions I went there, pushed for mammogram and cervical smears, refusing to take no for an answer and only sullenly accepting an “I’ll certainly consider it”. Had I followed doctors orders, I would have possibly been put through that grinder of radiation and mastectomy in my twenties!I

    By all the accepted medical “wisdom”,I should be dead right now. It’s horrifying that so many women who are in my shoes are out through one of the greatest medical nightmares, aggressive cancer treatment, for something that would likely clear up on its own.

    • Sounds like you might have missed a bullet, Naomi
      I always give my body a chance to resolve a symptom, it happens almost all the time.
      I sometimes need help if I’m in a humid climate and my dermatitis flares but so often we just need to to be patient, give our body time to sort itself out.
      Of course, worsening or persistent symptoms are another matter, unless we’ve had it before and know what we’re dealing with…I don’t rush to the doctor with dermatitis, I know the drill.
      I feel we know our own body best, what’s normal for us.

      I’m very cautious with screening, you’re messing with an asymptomatic body, I don’t believe in looking for problems because after a certain age – you’ll find a multitude of “abnormalities”. I think if we look hard enough at any age, there will be the unlucky people who get caught up in the screening merry-go-round, false positives, excess biopsies, scans, surgery and even unnecessary chemo and radiation. In fact, only a small number are actually helped by screening, that’s why it’s outrageous that women’s screening, in particular, is painted as a no-brainer, we’re judged idiots and reckless with our health if we want more information or decline.
      If you have a strong family history, you still need to do your reading, we can’t rely on recommendations, even the UK’s Professor Susan Bewley, with a strong family history of breast cancer, has declined mammograms, why? She’s aware of the evidence and was able to make an informed decision, every woman is entitled to make an informed decision.

  5. I wonder if any of you are concerned about being judged by doctors if you eventually receive a breast cancer diagnosis, i.e., “What! You weren’t having mammograms? My God!” There is a possibility I may get breast cancer as I have several risk factors (my sister had it, and it never showed up on the regular mammograms she was having by the way) and I do think of this. I would say something like, “Is it definite a mammogram would have made a difference?” Its just something I think about and I’m so sick of feeling like a pariah for making an informed decision, after weighing the risks and benefits, of this screening test.

    • If I ever have to report with breast cancer symptoms, I’d go armed with a copy of the Harding Center infographic available here:
      https://www.harding-center.mpg.de/en/fact-boxes/early-detection-of-cancer/breast-cancer-early-detection
      It shows that there is virtually no difference between going to mammos and not going, your survival odds are the same, but if you do attend screening you are likely to die sooner due to the additional side effects of chemo and radiation. No doctor can argue with this information. I am confident in not going. Knowing that my odds are the same I’m confident in arguing the point with anyone.

      • Thanks for the link, will print it out and add it to my arsenal. I was ambushed at a doctors appointment recently with an unwanted discussion about mammograms I was ill prepared for so will bring this material with me the next time I go along with articles by H Gilbert Welch who many here are familiar with.

    • Judy my mother died of breast cancer when she was 36. I was having mammography until I did my research. I was horrified when I learnt about the rates of overdiagnosis and overtreatment. I got called back twice because the mammogram is useless if you have dense breast tissue. Since doing the research I firmly decline all screening. I truly believe that I have dodged a bullet. Amazingly, I also have an intact cervix inspite of the NHS cervical screening programme. I would love to be in my twenties again with the knowledge I have now.

      • Wow, I’m very sorry you lost your mother so young. That’s where all the millions going into the mammogram industry should be going – finding a cure for metastatic breast cancer. There has been no reduction in breast cancer deaths since mammography became widespread. Rather it finds a lot of indolent tumors that never would have bothered a woman in her lifetime, subjecting her to toxic treatment that can itself harm her health.

      • Ah yes. Same old nonsense we’re getting about cervical screening: Women are “too busy”. The tests are only offered during work hours. And, the persistent lie: “Breast Cancer is the #1 cancer effecting women”. I don’t know about Britain, but the #1 cause of cancer deaths in the US is lung cancer – the same as men.

  6. I don’t have mamms. I dont fear being judged if i ever get breast cancer. No doctor will get away with looking down their nose at me. The way i feel about how i was treated by their precious cervical screening programme it wouldn’t take much for me to reach out and thump one anyway.

    • Your outlook is spot on and one I am going to adopt. I’m very sorry you were harmed by the cervical program. In the UK and Australia it’s all about what’s best for the program and in the US it’s all about what’s best for the industry – in both systems women come in dead last.

    • Judy that’s interesting though annoying. .you getting ambushed about mammograms. I got ambushed plenty about smears but no one mentioned mammograms to me. Maybe they gave me up as a hopeless idiot lol…

      • Oh, it was annoying alright. Especially since I had declined one during a recent visit and the doctor seemed ok about it then. He brought it up again using a different tone and I was caught off guard. I’m not sure where you’re from – Australia? – but there’s great pressure to have pap smears in the US too. But I think once a woman is in her 40’s and especially her 50’s, as I am, the pressure to have mammograms is even more intense here because it’s such a lucrative industry in our for-profit healthcare system. I feel I will be given up as a hopeless idiot too, soon, after declining these screenings, but you and I know who the real hopeless idiots are!

    • I feel just the same. I could wipe the floor with any doctor; quoting all the research at them. It is so empowering being informed and those of us with daughters can impart our knowledge. They will never be coerced or misled as we were.

  7. goddess bless this blog. i love that everyone here is supportive, posts news stories and scientific/medical journals, and are all interested in real numbers and science. it’s wonderful both as a woman and someone with a chronic illness.

    • It’s good to know that others find this blog so informative, endlessleeper. I always keep an eye out for new posts and it’s great that others post the latest screening news so we can be informed of what they’re up to.
      On the topic of breast cancer, here’s another about the new report which came out recently that they’ve worked out that substantial numbers of women didn’t need chemo after all. Great news that we now have this test, but what about those women who have had chemo before the test came out and for those whose cancer was only detected by screening?
      https://www.vox.com/2018/6/5/17426730/breast-cancer-chemotherapy-stamp-oncotype-dx

  8. Unnecessary chemo is a disaster…it causes so many health issues and can expose you to risk in the future from other cancers and heart disease. I wonder how many women have died as a result of over-treatment…
    Collateral damage that could have been avoided…even now they push and protect screening with all we now know about these screening tests…the “actual” benefit (if any) and the harms.

    • In his book “Mammography, truth, lies” etc by Peter Goetzsche, there is a whole chapter on Prof Duffy’s discrediting campaign against him and what Duffy did to dismiss Goetzsche’s claims. Duffy is fiercely protective of the UK screening programme.

    • Thanks kiwicelt, LOL In the wake of……
      The NHS data comes in the wake of a breast cancer screening scandal earlier in the year, which saw thousands of women miss out on their invitations for the routine tests.
      OR maybe these women have re-examined the more honest leaflet provided for breast screening? Not dented by the admin blunder earlier.
      But I see “we must act now to reverse this trend” and “we need to do everything we can to make the most of it, including by improving attendance”
      Cervical smear gets its mention with the “we should be doing our utmost to ENCOURAGE more to have smear tests”! Infuriating!

      • It blows my mind that the NHS and screening charities want to pin falling attendance on anything other than women becoming informed and choosing not to screen.

        The letters, embarrassment, lack of appointments etc are all wheeled out for cervical screening. I feel they have less options for breast screening but they will try anything rather than admit women are exercising their right to say no and with good reason.

  9. Did anyone see this Adam Ruins Everything: The Truth About Mammograms?! Funny and informative. Particularities when she argues with The doctor by pulling fistfuls of propaganda pamphlets out of her purse! Though it would have been nice to point out that if you do feel a lump,smashing it flat might not be the best or safest course of action in case it’s cancer.

  10. If only women got that sort of information from their doctor…but I don’t agree the issue is clearer in your 50s or older, IMO, the risks still outweigh the benefits. It’s a firm NO for me at any age.
    I agree…if you find a lump, see a doctor…and an ultrasound might be the best starting point, I definitely wouldn’t agree to a mammogram, crushing a breast lump is not a good idea.

  11. Sure that’s why our program was extended to include women aged 71 to 74…they’ll be screening at nursing homes the way things are going…more and more women know something is off with breast screening. The move is about saving the program, not women

  12. Interesting comments from ppl in this…and not just from us! Quite a few point out its a choice some say they won’t nuke and crush their bobs and some are aware of false positives and negatives. Maybe the word is getting out?

    • Ada

      Hardly surprising, but they’re keeping this quiet, I could only find one article discussing the research and of course, Professor Vested Interest (who works for BreastScreen) has hit back at the research. (in that one article that few women will find) with the usual, “I certainly hope this doesn’t put women off screening”…that’s literally all they care about, just keep those bodies coming through the door.
      Robert Burton works with Robyn Bell, impressive people, Dr. Bell was brave enough to release her article to the media, I hope her colleague does as well.
      How dare they keep this incredibly important research from women – when will that be viewed as totally unacceptable – if it was favourable to the program, it would be the lead story on the News

      • https://www.surveymonkey.co.uk/r/WQCSRZM

        Another UK survey, which folks might be interested in filling in. I almost didn’t go ahead with it, as they say they will make a donation to those dreadful pink charities, but the survey still works if you don’t select any charity. There’s a questionnaire for both smears and breast screening.

    • They’ve certainly piled in on Daniel Corcos. Very much dislike how he says cervical screening is useful and safe. For whom, I wonder? I think they are seriously worried about screening uptake in the UK after COVID. They’ve been forced to admit it is not urgent and can be put off, to the dismay of many. Stay well everyone!

  13. Ada, done the cervical and breast ones! I was pretty outspoken too, you all know me by now! Stay safe n well all, x

  14. https://www.healthwatch-uk.org/news/208-agex-ends.html

    Interesting news from the UK, where there has been a quiet downsizing of the breast screening programme.

    The AgeX trial unofficially recruited women from outside the normal screening age range (50 -70 in UK) and sent invitations to women in their late 40s and early 70s to get extra mammograms. I didn’t get one in my area but my sister did and assumed the NHS was just being extra efficient. There was no information that you were taking part in a trial – it looked just like an ordinary screening summons, so many women attended. There has been no public announcement, largely I think, because they don’t want a backlash from the screening zealots, whipped up to a misguided feminist frenzy by the tabloid press. Let’s hope it doesn’t come to that.
    I have long suspected that part of the reason for AgeX was to bolster falling uptake figures in the actual programme.
    Will be interesting to see how the figures fall without these extra women taking part.

    • From the article an older lady called Pat said
      “I live in a retirement village and when I was diagnosed a number of women of all ages went to be checked out and five had to have surgery of some type. It [the risk of breast cancer] just doesn’t stop at 69,” she said.
      Horrendous that her actions triggered all that overdiagnosis and overtreatment!

      • Some reasons why I don’t participate in breast cancer screening mammograms.

        1. Radiation. While claims of modern mammogram machines use less radiation, I have no idea what old equipment the for-profit-clinic that does mammograms where I live uses.

        2. Recommendations to avoid false positives for breast screening include not using any deodorants, antiperspirants, perfumes, creams in the breast area before a mammogram. Especially pesky is zinc oxide ointment (diaper rash cream) which I use for deodorant. It is difficult to wash off completely. It will show as white spots in the mammograms. Of course anything that looks like a calcium deposit is supposedly cancer. Only 2% of calcium deposits in mammograms are cancer. But when it doubt just give cancer treatment anyway.

        3. Recommended to avoid caffeine for two weeks before a mammogram. Realistically, how many woman are going to give up their morning beverage?

        4. Mistakes in mammograms. I was really surprised by this article. https://oncohemakey.com/analysis-of-calcifications/ Mistakes can be from cosmetics or medications on the skin, on the machines or just hand prints.

        5. Women are urged to take calcium supplements but where exactly is all this calcium going. 99% of it should be going to bones and teeth but the rest can end up in other places of the body where it can make problems. Usually the discussion of other vitamins such as magnesium, iodine and D3 are forgotten but necessary for proper use and balance of calcium. https://www.healthline.com/health/calcification
        “ Calcifications can form in many places throughout your body, including:

        small and large arteries
        heart valves
        brain, where it’s known as cranial calcification
        joints and tendons, such as knee joints and rotator cuff tendons
        soft tissues like breasts, muscles, and fat
        kidney, bladder, and gallbladder”

  15. It must be a breast hysteria campaign in the UK atm, today shopping I was asked if I wanted to round my shop up and donate to a breast charity… I declined!!

  16. New article in BMJ, obviously I could only access a bit of it, but it’s querying the use of financial incentives to drive up uptake, asking if women really are freely giving consent to screening, and pointing out the numbers of women having unnecessary treatment and suffering psychological distress through it all

  17. Does anyone have any information or opinion about 3D breast ultrasound?

    Apparently it is no radiation or much compression. The patient lays on their back and goop is put on and a mesh screen is pushed down and the scanner goes over, three views per breast. Some clinics offer it at cost $400 because public insurance does not pay and some clinics require a patient to have a mammogram first. If they find anything then they will go back over the suspected area with a handheld ultrasound and then biopsy.

    I might consider saving up for this to get my harassing family off my back for not having these cancer screening tests. Of course if a cancer is found then I might not want treatment like surgery, radiation, chemo.

    Compression and radiation are a concern for me with mammograms. The doctors always say that the new mammograms machines have less radiation but I am sure whatever clinic they send you to have old clunker deathray machines. Also I hear the horror stories of the “ductal cancer-in-situ” and women who had not so bad cancers the “first” and worse cancers and other problems such as blood clots due to cancer treatments.

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