Large Scale Screening Programs in Breast Cancer Prevention

The medical approach to managing any disease involves a combination of prevention, diagnosis and therapy. This applies to breast carcinoma as well. Primary prevention of breast cancer is not yet possible. Although the therapeutic methods have improved, there has been little change in the mortality from breast cancer (1,2). The only promising approach to reduce mortality from breast cancer is to treat the disease at an earlier stage, when the balance between the tumor and host is more favourable. The prerequisite to this is to detect breast cancer at an early stage. There has been a considerable improvement in the examination methods of the breast, especially of mammography, during the past two decades. Mammography alone has already demonstrated the ability to detect breast cancer at an early stage with high sensitivity and specificity (3,4,5,6,7). But it had to be proven in randomized, controlled studies that mammography as a screening modality will be able to eliminate from the breast cancer spectrum a significant number of advanced tumors and that it will lead to reduction in mortality from breast cancer.