A Working Group of 29 independent experts from 16 countries, convened by the International Agency for Research on Cancer (IARC) in November 2014, reviewed the scientific evidence and assessed the cancer-preventive and adverse effects of various methods of screening for breast cancer. This publication provides an important update of the landmark 2002 IARC Handbook on Breast Cancer Screening, in light of recent improvements in treatment outcomes for late-stage breast cancer and recent data on the effectiveness of organized screening programmes. The Working Group also considered non-mammographic imaging techniques, clinical breast examination, and breast self-examination.

Contents

• Note to the Reader
• List of Participants
• Working Procedures
• General Remarks
• List of Abbreviations
• Glossary
• 1. Breast Cancer
  • 1.1. The global burden of breast cancer: incidence, mortality, survival, and prevalence
  • 1.2. Classification and natural history
  • 1.3. Risk factors
  • 1.4. Stage at diagnosis, survival, and management
  • 1.5. Breast awareness, early detection and diagnosis, and screening
  • References
• 2. Screening Techniques
  • 2.1. X-ray techniques
  • 2.2. Non-mammographic imaging techniques
  • 2.3. Clinical breast examination
  • 2.4. Breast self-examination
  • References
• 3. Screening Programmes
  • 3.1. Determinants of participation in screening
  • 3.2. Availability and use of screening programmes
  • References
• 4. Efficacy of Breast Cancer Screening
  • 4.1. Methodological and analytical issues
  • 4.2. Mammography
  • 4.3. Clinical breast examination
  • 4.4. Breast self-examination
  • References
• 5. Effectiveness of Breast Cancer Screening
  • 5.1. Indicators for monitoring and evaluating effectiveness
  • 5.2. Preventive effects of mammography
  • 5.3. Adverse effects of mammography
  • 5.4. Cost–effectiveness and balance of harms and benefits
  • 5.5. Other imaging techniques
  • 5.6. Screening of women at an increased risk
  • 5.7. Clinical breast examination
  • 5.8. Breast self-examination
  • References
• 6. Summary
  • 6.1. Breast cancer
  • 6.2. Implementation of breast cancer screening worldwide
  • 6.3. Mammography screening
  • 6.4. Other imaging techniques
  • 6.5. Screening of women at an increased risk
  • 6.6. Clinical breast examination
  • 6.7. Breast self-examination
• 7. Evaluation
  • 7.1. Mammography screening
  • 7.2. Other imaging techniques
  • 7.3. Screening of women at an increased risk
  • 7.4. Clinical breast examination
  • 7.5. Breast self-examination

This publication represents the views and expert opinions of an IARC Working Group on the Evaluation of Cancer-Preventive Strategies, which met in Lyon, 11–18 November 2014

Lyon, France - 2016

IARC Handbooks of Cancer Prevention

In 1969, the International Agency for Research on Cancer (IARC) initiated a programme on the evaluation of the carcinogenic risk of chemicals to humans involving the production of critically evaluated monographs on individual chemicals.

The IARC Handbooks of Cancer Prevention complement the IARC Monographs’ evaluations of carcinogenic hazards. The objective of the programme is to produce and publish a series of critical reviews of data on the cancer-preventive effects of primary or secondary interventions, to evaluate these data in terms of cancer prevention with the help of international working groups of experts in prevention and related fields, and to indicate where additional research efforts are needed. The lists of evaluations are regularly updated and are available at http://handbooks.iarc.fr/.

This IARC Handbook of Cancer Prevention is partly funded by the French Institut National du Cancer (INCa) by Convention N° 2013-219 (HAP Dépistage 2013 - K sein).

Cover image: An oblique view mammogram of the left breast of an asymptomatic 57-year-old woman. The arrow points to a small invasive cancer detected at screening. This cancer could not be detected with palpation even after it had been detected with mammography. Photograph courtesy of Peter Dean.

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  Corrigenda to IARC Handbook 15. (PDF, 70K)

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International Agency for Research on Cancer

The International Agency for Research on Cancer (IARC) was established in 1965 by the World Health Assembly, as an independently funded organization within the framework of the World Health Organization. The headquarters of the Agency are in Lyon, France.

The Agency has as its mission to reduce the cancer burden worldwide through promoting international collaboration in research. The Agency addresses this mission through conducting cancer research for cancer prevention in three main areas: describing the occurrence of cancer; identifying the causes of cancer, and evaluating preventive interventions and their implementation. Each of these areas is a vital contribution to the spectrum of cancer prevention.

The publications of the Agency contribute to the dissemination of authoritative information on different aspects of cancer research. Information about IARC publications, and how to order them, is available at http://publications.iarc.fr/.