I’m a top women’s doctor and I would NEVER take up an invite for a breast screening. Women are being lied to by the NHS and this is the REAL truth about mammograms you must know: SUSAN BEWLEY

The adverts released this week by the NHS took a liberated, almost celebratory tone.

Featuring women ripping off their bras to a soulful Wilson Pickett soundtrack before sighing with relief, it was designed to focus women’s attention on their breasts.

‘Taking your bra off feels great – and so does getting your breast screening sorted,’ a voiceover says. ‘It can detect cancer long before you can even feel it or, more likely, put your mind at rest.’

It’s NHS England’s first national campaign to support breast cancer screening and aims to increase uptake of routine mammograms which are offered to women aged 50 to 71 every three years.

Why? Because uptake has been falling – the latest figures show one third of women invited for breast cancer screening don’t go. For those invited for the first time, it’s 46.3 per cent.

This, we are led to believe, is a disaster. Without screening, the NHS says, breast cancers may not be diagnosed or treated until far later – causing women to die needlessly from a cancer which can, largely, be treated thanks to huge advances in science and medicine.

The campaign was launched alongside a heartfelt letter from BBC presenter Victoria Derbyshire who was diagnosed with breast cancer aged 47 in 2015.

‘I’m still here thanks to the skill of the NHS – 2025 will be ten years since I was diagnosed,’ she wrote. ‘Breast screening might just help save your life. Please go.’ 

Yet none of this tells the whole story to women – the truth, the whole truth and nothing but the truth. I would go so far as to say that women are being lied to about the benefits of breast screening, and not being told at all about real risks.

I know that me saying this will cause understandable worry for many women reading this. It is natural, after all, to fear this disease and to assume that the promise of early detection can offer a better chance at a longer life, and better health.

But having examined the evidence behind screening, with increasing doubts, I know that it does not.

Let me explain – and then you can decide for yourself.

I’m a 66-year-old doctor and have spent my entire career dedicated to women’s health and evidence-based medicine. I also have a family history of breast cancer. My sister found a cancerous lump in her mid-40s, nearly 20 years ago. My aunt and grandmother were both diagnosed with the disease.

It is fair to say I am as terrified of getting the disease myself.

And yet, every three years, when that invitation for a routine mammogram appears through my letterbox, often increasingly aggressive in tone about the risks to my life if I don’t attend, I decline.

I’ve never had a screening mammogram, and I never will.

And here is the unpalatable truth they won’t tell you in the invitation at the clinic: by refusing a scan, I’m reducing my risk of being diagnosed with breast cancer by one third – a statistic which is backed by multiple studies.

What we know about screening is that it often picks up early cancers which will naturally disappear by themselves, or never cause symptoms.

For example, around 25 per cent of breast cancers picked up from screening are classed as DCIS – ductal carcinoma in situ – which means the cancerous cells are confined to the milk ducts.

Research suggests as many as 80 per cent of these may go away on their own, without invading the breast tissue.

But once spotted on an X-ray, doctors can’t yet tell whose will become a problem and whose will not – so they have to devise plans to treat them all.

It means some women are given a diagnosis and treated unnecessarily with biopsies, surgery and medication.

Once you have a diagnosis, you can’t take it away. You’ll always be a breast cancer survivor, and there is no one more grateful than a woman who’s been told she has breast cancer and believes her life is saved. The idea is you’ve dodged a bullet. But what if your cancer would never have progressed anyway? Then, I’d argue, screening has harmed and misled you.

This is illustrated really well in a diagram produced by the respected Harding Center for Risk Literacy, and based on data analysed by the world-renowned Cochrane Collaboration.

It’s the kind of diagram we should have on every leaflet and pinned up in every screening room so women know what they’re agreeing to.

It shows that, for every 1,000 women who undergo breast screening, four will still die of breast cancer and 18 will die from another type of cancer. They might be diagnosed earlier, meaning they have a cancer diagnosis for a longer period of time. But it doesn’t mean they will live longer.

Professor Susan Bewley says that screening, without symptoms, should be a choice

Also, a further 100 will not have cancer, but will have a ‘false alarm’ from screening – and need further tests or a biopsy to rule out cancer. 

Five more in every 1,000 will also have all or part of a breast removed even though their cancer would not have progressed. 

The diagram also shows what happens to 1,000 women like me who do not have breast screening. In this scenario, five die of breast cancer – an extra one woman in 1,000. Of course, over a larger population this becomes more significant.

The same number overall die from any kind of cancer.

But none are harmed by unnecessary worry, treatment or surgery.

The authors at the Cochrane Collaboration further clarify that if they just looked at the most robust studies, they showed that screening did not reduce the number of deaths from breast cancer at all.

We all like to think we’re the one person in 1,000 – that screening has saved our life – but none of us will ever know. We’re statistically more likely to be the ones harmed unnecessarily.

What the diagrams don’t show is the potential and reasons for other harms – for example, that the dose of radiation used in a mammogram can actually cause an extra 1.3 cases of cancer in every 100,000 women screened over a lifetime.

Prodding early cancer cells because they look ‘suspicious’ might turn them into more advanced ones capable of growing and spreading.

Sometimes when you stick a biopsy needle into a tumour you get a few cancer cells seeding along the path of the needle. They might otherwise have stayed put and been harmless.

Of course, those in favour of screening will argue it has led to deaths from breast cancer falling significantly in the UK.

Just 40 per cent of women survived 10 years in the 1970s, compared to 78 per cent now.

But studies comparing countries with and without screening show parallel improvements in mortality rates. And the steepest fall in deaths happened in women under 50 not yet invited for screening – suggesting it’s the wonderful advances in treatment I’ve seen over the decades, not screening, should get the credit. We’re also still diagnosing significant numbers of advanced breast cancer cases – which, if screening worked, we should be seeing less often.

I’m not a lone voice here. Professor Mike Baum, the highly respected cancer specialist at University College London, who helped set up the screening programme in the UK, resigned in 1997 over what he saw as an issue of informed consent – women were being told ‘bigged up’ benefits of screening, but not being informed of the risks.

He told me that the idea that ‘early is better’ when it comes to detecting cancer only works if cancer cells follow a specific linear timeline – as in, they start small and then become lumps we can feel and then grow bigger and spread.

But as Prof Baum points out, that’s not what happens. In theory, cancers can regress, do nothing or progress in size. Some can spread, but they don’t need to grow for that to happen. The outcome depends on how those cells behave – not on whether you find them when they’re still tiny.

And screening can’t tell you that. It’s a snapshot in time, it can’t tell the future.

None of this means you should not go to the doctor if you notice something worrying. A new lump, discharge from the nipple or dimples on the breast should always be checked out.

If I had symptoms, I would see my GP in a shot.

If you or I have cancer in these circumstances, we’ll be in good hands and our prognosis is likely to be good.

Like my aunt and grandmother who both died of old age and my sister who’s still here 20 years later.

But screening, without symptoms, should be a choice – so when you see the latest television adverts, remember that it’s not the no-brainer it might appear.