Breast cancer overdiagnosis from screening mammography has been debated for many years, with estimates of over 50% when unadjusted and estimates of 1% to 10% when adjusted for breast cancer risk and lead time.1 Importantly, overdiagnosis should be distinguished into 2 types.2 Type 1 (obligate) overdiagnosis occurs when progressive cancers are typically diagnosed in older women who die of other causes before the breast cancer becomes clinically evident. Type 1 overdiagnosis is intrinsically related to any program aimed at preclinical diagnosis of any disease, and its estimation is challenged by the continuous increase in life expectancy across all countries. In fact, the American Cancer Society takes into consideration life expectancy for the definition of the upper age limit for screening mammography.3 Neither radiologists nor pathologists can be in any way blamed for type 1 overdiagnosis and its related overtreatment.
Sardanelli F, Trimboli RM, Tot T. Expert Review of Breast Pathology in Borderline Lesions: A Chance to Reduce Overdiagnosis and Overtreatment? JAMA Oncol. 2018;4(10):1325–1326. doi:10.1001/jamaoncol.2018.1953
Artificial Intelligence Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.