Breast Cancer Screening: Controversies

Breast cancer is the most common malignant tumor in women. Breast cancer screening plays a key role in the it’s early detection, but i effectiveness of screening depends on many factors. Objective . To summarize the results of modern studies on the effectiveness of breast cancer screening, to identify contradictions in its implementation. Materials and methods . The systematic review of original publications and reviews was performed. The study included publications in the PubMed, eLIBRARY and Google Scholar databases for the period 2020– 2025, using the keywords "breast cancer", "screening", "screening effectiveness". Research results . The article provides a detailed description of the effectiveness of diagnostic methods that have been proposed at different times as screening methods: breast self-examination, clinical breast examination, breast ultrasonography, mammography, tomosynthesis, breast magnetic resonance imaging. According to the recommendations of the World Health Organization, the European Society for Medical Oncology, the National Comprehensive Oncology Network, and the Russian Association of Oncologists, the main method of breast cancer screening for women aged 40–74 is mammography, performed every 2 years or annually. The contradictions of screening are caused by the possible occurrence of psychological stress, the risk of obtaining an incorrect conclusion, which is associated with the imperfect accuracy of mammography. This requires additional costs for additional examination and retreatment of non-neoplastic diseases. In addition, there is a possibility of implementing interval breast cancer between screening rounds, which is prognostically more unfavorable. To achieve the main goal of screening, it is necessary to adhere to the recommended breadth of population coverage, which is not observed in many countries of the world due to low compliance of the population with medical services, insufficient awareness. Conclusion . Thus, despite significant success in the implementation of breast cancer screening, there are still unresolved contradictions. They can be eliminated by conducting further research to increase the effectiveness of screening programs and improve the quality of medical care.