Top doctor says breast cancer screening does 'more harm than good'

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Surgical oncologist Professor Michael Baum, of University College London, specialises in breast cancer treatment, and was one of the architects of the screening programme when it was set up in 1988.

More than 25 years later, he has called for the programme to be shut down, arguing it leads to healthy women being labelled 'cancer victims' and has not reduced the number of invasive tumours.

But Dr Michael Michell, a consultant radiologist based at King's College Hospital, insists cancer screening saves lives and would like to see women screened every two, rather than three, years.

Below, they lay out their arguments on whether or not the programme should be scrapped.

Michael Baum, Professor Emeritus of Surgery and visiting Professor of Medical Humanities in University College London, is a British surgical oncologist who specialises in breast cancer treatment.

Back in 1998, in all good faith, I set up the service for the NHS Breast Screening Programme.

Since then, I have become one of the most vociferous proponents for closing it down.

You probably want to know why I changed my mind so completely.

At the heart of this is the question, how do you explain to a woman that she is 'lucky' that we caught breast cancer early yet she ends up having a mastectomy?

And that she probably wouldn't have needed treatment at all if we hadn't called her in for a routine scan?

This is because mammograms can pick up a type of low-grade breast cancer called duct carcinoma in situ (DCIS), which is contained just in the milk ducts and has not spread into any of the surrounding breast tissue - about 60 per cent of DCIS cases are picked up by routine breast screening.

Around half of these cancers turn out to be harmless. It is my view that too many healthy women are harmed by breast cancer screening.

Healthy Women Labelled Cancer Victims

Unlike most of the other members of the National Committee, I was directly involved in the day to day care of those women referred on to me as a consequence of the activities on the front line of the screening program.

I found it very distressing to have to cope with otherwise well women who had popped into the screening unit in Butterfly Walk for a mammogram at the invitation of the Department of Health (DoH) and then found themselves labelled as a cancer victim.

Worst of all were the unexpected high numbers diagnosed with duct carcinoma in situ (DCIS), a condition we rarely saw before screening began.

Many of these cases were multifocal and ended up with a mastectomy, yet they may well have turned out to be harmless.

None of the Department of Health staffers or public health specialists on the National committee had to face the reality of these heart-breaking interviews.

We were soon to learn that 20 per cent of the cancers diagnosed in Butterfly Walk were DCIS, yet before we opened our doors they amounted to less than one per cent of our practice.

I drew short term comfort from this observation assuming that in the fullness of time this initial peak in the incidence of DCIS would be followed by a fall in the incidence of invasive breast cancer.

I couldn't have been more wrong.

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