Statement: ‘Breast cancer screening should be different NOW’

The breast cancer screening program is a success: breast cancer mortality has been reduced by 40 percent since the screening was introduced in 1990. But there are also drawbacks. During a mammogram, the breast is ‘squeezed’ between two plates, which is a painful experience for many women. In addition, a dose of harmful X-rays enters. The mammogram is not very accurate. It misses a quarter of the tumors. It also points out ‘abnormalities’, which later turn out not to be cancer. Very dense breast tissue is difficult to map, which is 160,000 of the participants. That could be better, everyone agrees on that. But how fast?

Radiologists now want change

The advantage of the MRI is that it works better with very dense breast tissue, according to the DENSE study. Radiologists are therefore now calling for an additional MRI scan for women with very dense breast tissue. And in the long term for another screening, without a mammogram, for example with an MRI or ultrasound. Anyway – the radiologists now want an improvement in breast cancer screening.

Minister Blokhuis wants to wait

However, Minister Paul Blokhuis of Public Health has rejected this proposal, according to his letter of 24 September. However, the MRI is much more expensive and takes more time in overcrowded hospitals that are already almost unable to cope with the population screening and are allowing the interval of two years to increase. You can’t just change a population screening. It is too large-scale for that and there are too many interests at play. Blokhuis therefore relies on the Health Council, which is not so convinced of the added value of MRI. More research is needed into a different method (called CEM) and a study into its practical feasibility. This will take at least another six years, only then will we know which is better and whether it is feasible. That is a long time, Blokhuis agrees, who will look for an interim solution.

What do you think? Respond to the statement: ‘Breast cancer screening should be different NOW’

At sometime

It’s taken long enough. The discussion about the disadvantages of the mammogram has been going on for at least ten years, as shown in this 2011 Plus article. No more dawdling with examinations or hassle about money. Women have the right to a proper breast cancer screening. Then at least enter the additional MRI scan right away for women with very dense breast tissue.

Disagree

The breast cancer screening program is intended for a large group of women and is paid for by all of us. It is right that Minister Blokhuis is acting carefully, and is not giving in on the advice of the radiologists’ association or following a motion by the House of Representatives. Blokhuis follows the advice of the Health Council and that is in the Netherlands the institute that best weighs all knowledge when it comes to population screening. Let’s trust that. So please be patient.