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Advantages, disadvantages and limitations of mammography screening

The Québec Breast Cancer Screening Program (PQDCS) is for women aged 50 to 74. All women eligible for this program should learn about the advantages, disadvantages and limitations of mammography screening. Each can then make an informed decision about whether to participate in the PQDCS or not. If needed, you can talk with your healthcare provider to help make your decision.

Advantages

  • Better chances of cure: Because screening generally detects cancers at an early stage, they can be treated more effectively, thereby reducing the number of deaths due to breast cancer among participants.
  • Lower risk of dying from breast cancer: The number of deaths due to breast cancer is lower among participants in the screening program than non-participants.
  • Less chemotherapy: Because screening generally detects cancers at an early stage, they can be treated without using chemotherapy.

Disadvantages

  • Waiting and worry when additional tests are needed: Having to undergo additional tests and wait for the results often leads to worry and anxiety. However, in 95% of cases, the results of these tests are normal and do not reveal a cancer.
  • Complications: Complications may occur after additional tests (e.g., biopsy).
  • Disruption of daily routine: Additional tests may disrupt daily activities (e.g., absence from work).
  • Risk of overdiagnosis: Since screening can detect cancers in the early stages of development, some of them may be cases of overdiagnosis. This means these cancers would not have had consequences on the person’s life, because they would have remained inoffensive or would have developed very slowly. Since it is impossible to differentiate inoffensive cancers from deadly cancers, all cancers are treated. Thus, the person may:
    • receive needless treatments;
    • suffer the side effects of these treatments;
    • have to live with a cancer diagnosis;
    • have more frequent medical appointments to ensure the cancer does not reappear.

Limitations

  • Mammography does not detect all cancers. Some are invisible on the mammogram or may develop between two mammograms.
  • Having a screening mammogram does not guarantee that you will survive a breast cancer.
  • Treatment does not always lead to survival, even when a cancer is detected at an early stage.
  • Screening mammography does not prevent breast cancer from developing.

Last update: March 11, 2024

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