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The follow-up of patients treated for invasive breast carcinoma remains a major challenge because of breast cancer prevalence and the frequent patient's preferences for a regular follow-up. Concerning this last point, there is a lack of studies about the consequences of a systematic follow-up. Few decades ago, regular and systematic follow-up was considered as a dogma. In 1994, it was seriously questioned by two randomised Italian trials: they did not find any benefit in terms of survival and quality of life in patients who had a regular search of asymptomatic metastasis. Follow-up strategy after early breast cancer is still an unexplored field, despite higher performance of investigation tests and development of new treatments strategies that allowed a significant decrease of recurrences and increase of cancer care. Currently, the international guidelines deeply recommend a regular physical examination and mammography. But a systematic search for non-symptomatic metastases is unnecessary. We now need a coordination between practitioners to avoid useless tests, and to respond to patients’ will. [Copyright &y& Elsevier]

Objective: Study the contribution of breast cancer screening by mammography on the quality of diagnosis and treatment of patients admitted at Saint-Etienne University Hospital between 1985 and 2005. Patients and methods: Descriptive and retrospective study of 473 breast cancer patients between 1985 and 2005, with a stratified sampling over the year, and comparison of the various characteristics between detected and not detected patients. Results: Patients diagnosed by a mammography screening present, in a statistically significant way, smaller size tumours, less nodes and metastatic attacks, more conservative surgery and less chemotherapy. The rate of global survival after years years is increased: 93.69% against 86.94% for patients who did not participate in an organized screening (p =0,0471). Discussion and conclusion: Mammography screening allows optimization of the health care. In the next years, we should continue the development of mass screening and convince the actors of individual screening to join organized campaigns. [Copyright &y& Elsevier]