Chapter 5: Breast Cancer Screening
V-348 Management Science
November 21, 2013
Shota Nakano, Xinye Wang, Xinhui Du

Abstract
A breast cancer screening is the medical screening that is a method used in a population to identify an unrecognized disease in individuals to find asymptomatic. That is conducted a number of screening tests including in clinical and self-breast exams, mammography, genetic screening, and magnetic resonance imaging. These are available to help women for longer life expectancies; however, not all screening tests have been shown to benefit the person being screened by over diagnosis, misdiagnosis, and creasing a false sense of security are some potential adverse effect of screening that we learned in the class that the outcome was sometime inaccurate. For these causes, a test is used in a screening for especially low incidence, so to improve the screening, it must have good statistical measure of the performance to identify the disease. In addition, the outcome of the test will be variation by the ages. As a matter of fact, women in the ages of 50s can be increased the number of accuracy since the age is the top to have a risk for the breast cancer. Next, another issue is the inaccurate test result will give women anxieties since the test will been conducted several times and with false positive women have to experience unnecessary treatments and re-screening for disease.

Background A breast cancer screening is the medical screening to detect the breast cancer that harms to women. Since the development of the technology of the screening, the large number of women has been reduced the risk of the disease and this has been helping women for longer life expectancies. In fact, screening mammography has reduced the rate of death in the large population. For instance, compared with non-screening group, the screening has been succeed to reduce about 2.4 deaths per 100,000 person among the women between 50 to 69 years-old in the screening group, according to a clinical study conducted in Norway in 2010. However, the screening test has risks to be harmful from false positive that means the test result is false outcome by the test is very complicated and the disease is very rare. According to the Cochrane Collaboration (CC), “the effect was lowest in the adequately randomized trails, a reasonable estimate is a 15% reduction corresponding to an absolute risk reduction of 0.05% and screening led to 30% over diagnosis and overtreatment, or an absolute risk increase of 0.5%; this means that for 2000 women invited for screening throughout 10 years, one will have her life prolonged and 10 healthy women, who would not have been diagnosed if there had not been screening, will be treated unnecessarily.” Moreover, CC has reported that more than 200 women will experience physiological distress during the screening since the result is not accurate. To continue the discussion, the issue of the screening has only one issue, false positive findings, but also the test has potential risks of side effects since the screening has been conducted by several processes with increased surgeries, chemotherapy, radiotherapy and other potentially procedures resulting from the over-detection of harmless lumps. These will become causes many women experience physiological distress since the test is not perfectly accurate and it will give anxieties since the several tests has been conducted.

Simplify How the Screening Test is Inaccurate
Assumption:
1. The test has been tested 1,000 women’s sample, their age is 50s.
2. The screening has conducted every year for ten years.
3. The outcome are considered typical in the developed world.
Outcome:
One woman’s life is extended by earlier detection of breast cancer
2-10 women will be overdiagnosed and needless treatment experienced
5-15 women will be treated for breast cancer with same outcome as if they had been detected after symptoms