The goal of breast screening is to prevent death and not simply to detect cancers by mammography. Mammography does detect some cancers "early," but many of these are not potentially lethal and their detection causes needless anxiety. Clinical breast examination is more likely to detect cancers that are potentially lethal. Results of the second Canadian national breast screening study suggest that mammographic detection of cancers that are not palpable does not affect mortality. New GMC guidelines on informed consent state that women in the NHS breast screening programme should be informed of the drawback: of mammography as well as its potential benefits. A national questionnaire survey is needed to determine if women would prefer clinical breast examination to mammography and whether a randomised trial comparing the two would be acceptable.
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