[hutchibk]

Hey DL, I would like to take a stab at an alternate take on your conclusion....

Even if there were no harms, why would we advise doing something that makes no difference to outcome?

Nothing makes a difference in our ultimate outcome. We all die one day. From something. If not from a disease or an accident or an act of malice, then from old age. There is no such thing as "saving a life" - it should actually be called "extending a life" - even if it is a firefighter pulling a person out of a burning building.

I really bristle at the theory of "harms caused by hyper-vigilance" because I think women are emotionally strong enough to weather false positives in favor of the power of knowledge.

If the end purpose for all research is to save lives, then we might as well stop now, as nothing in the end will ultimately "save our life." Perhaps the end purpose for all research should be more simply stated as designed to cure disease and remove it as a speed bump in the middle of life along the way to the ultimate outcome all humans face.

As to the quote above, it does make a difference to outcome to the degree that we have some control over our immediate short term outcome. Finding it as opposed to not finding it allows us to take measures to extend our lives, i.e. treating it. I don't know for sure whether or not I would still be alive 6 years later from my diagnosis if I hadn't treated it or hadn't know about it for another few years, but I suspect that given the course of mine, I would not. I would rather have known early and had reasonably "small measure" choices that I tolerate well and incorporate into my life, than find out at stage IV and have less choices, less time and absolutely less hope. Whether that treatment cures it or buys more time, it is valid. And the diagnostics that brought me here (BSE, mammo, ultra sound and biopsy) are all valid, too.