Another item of the same ilk.
All studies need treating with caution. Definitions of outcomes could arguably significantly sway results, for example including any death after reoccurence as a death from cancer. Reoccurence is clearly more likely in an untreated group, but non survival may not necessarily be linked to cancer.
RB
http://www.natlbcc.org/bin/index.asp...nid=1&depid=20
ABSTRACT
That said, several cautions are in order. While meta-analyses provide valuable information when the effectiveness of interventions is considered at the level of larger populations, they are much less useful for the purposes of devising treatment plans that fit the specific circumstances of an individual woman's specific case. [See NBCCF Fact Sheet: "What is Meant by Breast Cancer Risk".]
NBCCF is particularly concerned about several important points. The first is that we must not lose sight of the fact that over-treatment of breast cancer remains a significant problem for thousands of women each year who are given highly toxic treatments from which they will not benefit. More research is needed to develop tools to help women and physicians better distinguish between tumors with good prognoses and those with poorer prognoses so that better treatment decisions can be made at the outset. [See NBCC Fact Sheet: "Gene Expression Profile Testing".]
In addition, this study is historical to a large extent, even though the therapies it examines are still in common use. Previously diagnosed patients are different from current and future patients in some essential ways, so the same treatments may well impact them differently. For example, higher proportions of women diagnosed today than those in this study will have earlier stage diagnosis, will get breast-conserving surgery instead of mastectomy, will undergo sentinel node biopsy instead of axillary node dissection, and will have the benefit of more sophisticated testing techniques, more detailed molecular profiling of their tumors, and more targeted therapies. It is impossible to know at this point whether these differences will mean that the treatments covered in this analysis will prove to be more or less effective than others that may be available for these patients.
Finally, we are concerned about overly sensationalized and inaccurate press coverage of this study. Karen Gelmon of the British Columbia Cancer Agency in Vancouver speculated in an editorial in The Lancet that accompanied the meta-analysis that "the survival curves suggest that adjuvant systemic therapies do cure a proportion of women with early-stage breast cancer, rather than simply delaying recurrence." Reports in several newspapers around the country picked up on and exaggerated this comment by reporting that this analysis shows that these therapies can cure breast cancer. While the analysis contains much valuable information, the fact is that over 40,000 women die from breast cancer every year, in spite of the fact that these very therapies have been in use throughout the 15 years that this study covers. The National Breast Cancer Coalition looks forwad to the day when we can definitively say that a cure has been found. Unfortunately, that day has not come yet.