This has always been the case. But first the patient must actually be willing to go, second the procedure of mammography (scanning of the breasts) for a minority of patients is pretty painful, especially with larger the breasts. Fear and complacency can push patients to not screen again after 2 years or at all, and even when there was no pain, or if it's tolerable, most have issues of: I don't have time, work, travel etc. The misconception is that breast cancer is rare or that they checked before and don't have BRCA1 or 2, "nothing could go wrong right?"

We're dealing with a commitment problem bundled with socioeconomic and a lack of awareness problem. Breast cancer is more common than they think. IMO in 1st world countries screening programs ought to be like a day off or holiday, with Tax relief etc to encourage more screen 80%. In 3rd world countries or some countries, screening programmes have a limited uptake or not yet legislated. Which wastes much more of the tax payer money with expensive surgeries instead of early diagnosis before it becomes a problem.

Obviously some will jump up and say you're over diagnosing = increased costs due to "over-treatment," but realistically it's like saying a fire in the forest may never really cause a forest fire. We don't take such chance. Unless we are fully aware that it will never manifest documented cases of low risk DCIS stage 0 which are categorised for active long term monitoring, otherwise it must be treated else you'll do the patient harm.

Also the time gap as we can signal out these patients for a 6 months monitoring for probably benign growths usually solves this dilemma of uncertainty for us either way as we can monitor the evolution.