In Shift, Cancer Society Has Concerns on Screenings

[Hopeful]

http://www.nytimes.com/2009/10/21/he...?_r=1&emc=eta1

Hopeful

[bejuce]

This article is very confusing and makes me angry. How can they say that breast cancer screenings may not be helping as much when more and more breast cancers are being diagnosed? The article itself says that "researchers report a 40 percent increase in breast cancer diagnoses and a near doubling of early stage cancers, but just a 10 percent decline in cancers that have spread beyond the breast to the lymph nodes or elsewhere in the body." The 10 percent decline is definitely due to the increased screenings, and the fact that there has been a doubling in early stage cancers is actually a good thing, isn't it? The overtreatment of these cancers is not due to the additional screening, but to the lack of understanding about how these cancers work.

There needs to be a focus on treatments that work, rather than debating whether the additional screenings are helpful. If one were to read this article and the NBCC recommendation that a BSE does not save lives, then how would a cancer be found??? I'm confused and angry at these mixed messages. I found my lump myself, and was refused a mammogram because I was still breastfeeding. If I had not been persistent, who knows where I would be now.

[Hopeful]

The controversy over mammography screening has been more pronounced in the UK, with the emphasis on providing better disclosure to those who agree to screening: http://her2support.org/vbulletin/sho...eferrerid=1173

Hopeful

[Rich66]

An update/clarification/CYA?

http://www.reuters.com/article/press...09+PRN20091021


But c'mon. You know about all those "unnecessary tests", right?
I'm not comfortable with it being ok to let other cancers get caught later based on rear-view mirror statistics or cost/benefit analysis. Cancer treatment is always evolving. Me thinks, find it early, treat it with what's available now until something better comes along.

In terms of disclosure, would be good for patients to know the false negative rate of mammo and let them make an informed decision on diagnostic tests. Yes, even if they have to pay out of pocket.

[Hopeful]

The end result, which seems to favor the UK approach:http://www.medicalnewstoday.com/articles/168274.php

"ACS chief medical officer Otis Brawley said, 'We don't want people to panic. However, he added, 'I'm admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.'"

Hopeful

[bejuce]

Sure, the advantages have been exaggerated, and better screening/diagnosis tests need to be developed. What's important is to not let these mixed and confusing messages make women think that BSEs and mammograms are not helpful and that they should not be doing any screening at all.

There are a lot of confusing and mixed messages and stats online and elsewhere and it is hard sometimes to digest them all. This morning, for example, I woke up with lots of hope and a new sense of normalcy as I had my last radiation treatment yesterday. Only to check my email on my iPhone and read an email from a woman in my local support group complaining of this very same article and quoting a figure that 40 % of all HER-2+ cancers develop brain metastasis. Reading that put me in a panic/depressive state of mind (I had not seen that before) until someone else pinched in that the 40% figure is for cancers that had already metastasized. So just goes on saying how important it is to read everything with a grain of salt and to always try to find the supporting evidence for those stats.

That's why I love this group - the most informed, non-judgmental people I have found so far.

[Rich66]

"40 % of all HER-2+ cancers develop brain metastasis."

Perhaps that will change with increasing use of Lapatinib.

[Hopeful]

Follow up analysis from today's New York Times: http://www.nytimes.com/2009/11/03/he...second.html?em

Hopeful