Breast cancer advice bid to stop needless operations.

Byline: Alan Roden Scottish Political Reporter

GUIDANCE on breast cancer screening is to be rewritten to prevent thousands of women having unnecessary surgery.

Cancer experts have condemned the existing NHS advice for Scots women as misleading, inadequate and patronising.

They believe leaflets are effectively manipulating women by promoting the benefits of screening, without flagging up the risks of potentially unnecessary surgery.

Under new guidelines, women in Scotland will be told for the first time that some cancers detected may remain dormant and never spread.

In research published earlier this year, scientists found that while one out of every 2,000 women screened regularly over ten years would have her life saved as a result, ten healthy women would also be treated.

Experts also said one form of cancer, called ductal carcinoma in situ (DCIS), was not likely to 'surface clinically'.

Dr Joan Austoker, director of primary care education research at Oxford University, said it had been a mistake to withhold information from women that treatment might not be necessary.

The Department of Health in England decided last weekend to rewrite its guidance on breast cancer screening as a result, and the Scottish Executive yesterday said it will follow suit.

A spokesman said: 'We are working with the Department of Health, using the same research, and we will also be updating our breast screening information leaflets. We would expect them to be ready early next year.'

DCIS accounts for around a fifth of all diagnoses by NHS screening. Although fewer than half of these dormant cancers will become invasive, a third are treated with mastectomies, the partial, or complete, removal of a breast. The new leaflet is expected to spell out the risks of unnecessary surgery.

The other dangers of breast cancer screening include not detecting the tumours and misidentifying healthy cells, so-called false positives.

Dr Austoker added: 'We want to make sure all the risks of breast screening are referred to in appropriate detail.

'Much of the ductal carcinoma in situ diagnosed will never surface clinically. Therefore it constitutes over-diagnosis - that is, you are diagnosing something that would not have become an issue.'

The UK was one of the first countries to establish a national breast screening programme. There are six permanent screening centres in Scotland supported by 19 mobile units.

Since 1991 there have been more than 2.1million screenings and in excess of 15,300 breast cancers diagnosed.

Over the past ten years, the proportion of cancers diagnosed before an operation has increased from 67.7 per cent to 96.2 per cent.

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Screening: Guidelines rewritten