Preventing overdiagnosis in mammography screening - a public health perspective.

Prevention and management of breast cancer in order to provide high quality health care is an important public health issue. The existence of overdiagnosis for breast-cancer was controversial for a long time but is now broadly accepted. Overdiagnosis is defined as the diagnosis of "disease" that will never cause symptoms or death during a patient's ordinarily expected lifetime. Estimates of the overdiagnosis rate for breast cancer range up to 54% of screen-detected localized tumors. New approaches, such as the identification of high risk groups or primary prevention approaches could be more relevant from the public health perspective.