Common position of the Ministry of Health of the Slovak Republic, the National Institute of Cancer, the Slovak Cancer Society and the main specialist of the MZ SR for radiology on the mechanised withdrawal of the proposal of members of the National Council of the Slovak Republic Zuzana Šebová, Monica Péter and Miloš Svrček to issue a law amending Act No. 577/2004 Coll. on the scope of health care paid on the basis of public health insurance and reimbursements for health care services as amended
Ministry of Health of the Slovak Republic, Prof. MUDr. Stanislav Špánik, CSc., President of the Slovak Cancer Society, MUDr. Mária Rečková, PhD., Director of the National Cancer Institute, Prof. MUDr. Viera Lehotská, PhD., head expert of MZ SR for radiology doc. MUDr. Jana Slobodíková, CSc., MPH, mim Prof., president of the Section of mammary diagnostics SRS SLS
sand identify with the draft law in question. These changes are based on scientific evidence and are also recommended by working groups of MZ SR. This proposal also regulates other much needed changes not only in the field of oncology screening but also in the care of paediatric patients.
Breast cancer screening is designed for symptomless women. A mammographic examination is clearly recommended in screening of women at normal risk for breast cancer development. Ultrasonic examination may have its meaning in resolving mammographically dense glands, or established mammographic abnormalities, or in women with symptoms of mammary gland disease. Conversely, in screening of non-symptomed women at normal risk of breast cancer, ultrasound scans are itself associated with high false positives and are not recommended as screening tests.
For women at higher risk of developing breast cancer and for women with clinical findings on breasts, separate standard investigation procedures are developed. Separately performed ultrasound examination in non-symptomed women may lead to an over-examination, due to repeated oncology-related changes (cysts and benign palpable changes) leading to potential damage and excessive anxiety of women. At the same time, they represent a burden on the health system.

The European Radiological Society and the European Breast Imaging Society (EUSOBI) clearly do not recommend the use of ultrasound scans as a preventative method of breast cancer, given the results of long-term application practice based on medical evidence.
The draft amendment of the law is in line with the medical recommendations, which, inter alia, regulates the medical procedure correctly mentioned concerning ultrasound testing of the mammary gland in women at normal risk for the development of breast cancer.
The proposed amendment should thus ensure greater access to medically indicated radiological examinations. The result of sonographic prevention is an increase in the number of additional examinations, biopsies and earlier benign lesions to confirm their benignity. This has a negative impact on women's psyche and on the cost-effectiveness of such a preventive programme and does not meet the required criterion of sufficient advantage over the risks both for the individual and the population.
For the above reasons, most professional companies and experts do not recommend routine screening of breast cancer in young asymptomatic women at an average risk of less than 40 years because it is not effective, does not lead to a desired decrease in mortality and, conversely, results in a disproportionate iatrogenicisation of healthy women (damage to the patient through incorrect procedures).