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Old 09-27-2007, 12:05 PM   #1
Lani
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who are the American Cancer Society (a Political action committee &hopefully consumer

activists) to formulate guidelines for who should and shouldn't get MRIs, when the MDs make different recommendation?

. I can understand that they may feel that radiologists have a vested interest (although it is not that simple because they make money from mammograms, ultrasounds, etc and more of them can afford them). Again, it does not address subtypes of bc:
New guidelines from the American Cancer Society (ACS) recommend that women at very high risk for breast cancer receive magnetic resonance imaging (MRI) along with annual mammography, reports the October 2007 issue of Harvard Women's Health Watch.

In one recent study comparing MRI, mammography, and ultrasound in 171 women whose lifetime risk of breast cancer was very high (20% or more), MRI proved best at finding cancer. Of the six cancers diagnosed, MRI detected all six, mammography only two, and ultrasound only one. Only MRI detected the four cancers found in women with dense breast tissue.

Even so, the ACS and other groups don't recommend routine MRI screening for women at average risk, for reasons such as these:

-- It leads to too many unnecessary biopsies. MRI picks up any abnormal tissue, whether cancerous or not.

-- Mammography is getting better all the time. Digital mammography works better than traditional mammography in women with dense breast tissue and is becoming increasingly available.

-- MRI has limitations. It can't be performed on women with pacemakers or implantable cardioverter-defibrillators, and its ability to detect some early cancers is limited. It also isn't widely available.

-- It's expensive. And insurance won't pay for it for women at average risk.

-- It's unclear whether MRI helps women live longer. The most important outcome of any screening test is improved survival. We don't know yet if using MRI helps women live longer.

For most woman over 40, having an annual mammogram and clinical breast exam is still the best way to catch early-stage, highly treatable cancers, says Harvard Women's Health Watch.

Sorry to editorialize again!
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Old 09-27-2007, 01:46 PM   #2
hutchibk
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After reading about their plan to spend their entire millions of $$ of advertising budget for '08, on pushing for national government health care, I am not a fan of the ACS...
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Brenda

NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."
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