The pro-screening lobby is locked into a mindset dating back to the late 1980s. Since then our understanding of the biology of breast cancer and its treatment has moved on whilst the screening programme continues without modification based on the results of trials reported in 1987. This lecture will discuss some of the harmful problems of this over-diagnosing system, and will look at the need for radical change to bring the entire programme up to date with modern practice based on risk assessment and risk management.