In October 2011, it was announced in the UK that an independent review of the evidence underpinning breast screening was to be undertaken by Professor Sir Mike Richards (National Cancer Director for England). The Department of Health’s current arrangements for breast screening remain in place and unchanged, and all women who are invited for screening should continue to attend.
 
The review comes amidst debate amongst professionals on the potential harm caused by screening, such as false positives which can cause emotional distress and lead to investigatory procedures to determine if breast cancer is present.  However Professor Richards has suggested that for every false positive/over-diagnosis, up to two and a half lives are saved.  The World Health Organisation estimates that screening reduced deaths from breast cancer by around 35%.
 
The review, which is being carried out in partnership with Harpal Kumar, the Chief Executive of Cancer Research UK, comes at a time when the NHS is looking to expand the age range for breast screening from the current 50 – 70 years of age, to 47 – 73 with the programme due to be fully implemented by 2016.
 
Minister for Health, David Anderson MHK said: “The Department monitors developments in screening in the UK very closely and acts on the best clinical advice.  With this review underway, the debate about extending breast screening in the Isle of Man to those aged between 47 to 49 and 71 to 73 is premature.  The outcome of the review may not only impact on the extension of the breast screening age range currently being rolled-out in the UK; but also the clinical evidence underpinning breast screening itself and whether or not screening of the breast is necessary.  The message for now is clear: women should continue to attend their breast screening appointment when called and I strongly encourage them to do so.  Naturally, we will update the public when the Department makes any decisions following the conclusion of the review.”
 
Breast Screening in the Isle of Man currently sees women aged between 50 and 70 called for screening once every two years – as opposed to every three years in the UK.  The Department also operates a state of the art digital mammography machine (a specific type of x-ray machine for scanning the breast), which produces higher quality scan images.
 
Dr Parameswaran Kishore, Director of Public Health said: “Ever since the Forrest report was released recommending breast screening for women aged 50 – 65 there has been controversy about the effectiveness and the harm/benefit ratio of breast screening.  This debate has been reignited in medical press within the past year; studies from different parts of the world  - Denmark, the USA and Canada - have cast doubts whether the observed reduction in mortality from breast cancer is attributable to breast screening.  It is to settle this argument that Professor Richards set up a review.  It would be premature to consider any changes to the Island’s Breast Screening Programme until Professor Richard’s review is published and the Department has had a chance to examine the report and the reaction from international experts.”
 
The Department offers breast screening for women aged over 70, providing a reminder card at each patient’s final call/recall appointment.  The card contains the Screening Unit’s phone number, the patient’s personal reference number and a reminder of when their next appointment is due.  All the patient then has to do is ring up when their next screen is due and an appointment date will be provided and a further reminder card issued.  Those over 70 can self refer for screening at any time simply by telephoning the appointments office on 685339.
 
The outcome of the UK review is expected before the summer, although it could be some time before any recommended changes are agreed and implemented in the UK.  The Department will continue to monitor developments closely in the UK before any decision is taken in relation to changes to the Isle of Man’s Breast Screening Service.
 
Five point plan for breast care:
1. Know what is normal for you
2. Look at and feel your breasts
3. Know what changes to look for
4. Tell your doctor about any changes immediately
5. Attend for breast screening if aged 50 or over.
 
Anyone concerned about their breasts should contact their GP in the first instance or call the Breast Screening Team on 685339.
 
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