roamingguy 300292 Report post Posted November 22, 2011 Something on CBC News RG http://www.cbc.ca/news/health/story/2011/11/21/breast-cancer-screening.html Quote Share this post Link to post Share on other sites
Code Blue 3585 Report post Posted November 22, 2011 This debate has ben active for at least 35 years that I can recall. As with a lot of things there is no perfect information: each of the trials has some degree of technical flaw which is then used by those of a contrary viewpoint to trash the whole paper. For the general i.e. low risk population of women, there is no benefit to screening outside the ages 50-70. No-one lives longer or better if screened more often that every two years. Yes, there are anecdotes, narratives of "saves" which carry a weight beyond the numbers but at the population level - and that is what screening is about - they vanish in analysis. For those with a family history and genetic markers things are different: they account for less than 10% of patients with breast cancer - and I can hear the replies now about granny who had it starting up. (If a woman lives long enough she will develop breast cancer, just as a man will do with his prostate. At that time of life it does not shorten our time on earth. ) Initially the downside of screening was XRay exposure, but now it is something much more awkward to manage. Modern techniques of mammography with greater sensitivities have been introduced with limited trials and have multiplied the number of "shadows" needing further, usually surgical intervention. While technology has diminished the magnitude of the invasiveness of these biopsies, nothing has diminished the almost paralytic fear generated in ladies with a "positive" finding. Most (in excess of 70%) of these biopsies are "normal". Few of those classed as not normal are anything other than problems which are managed simply by more mammograms, "just to keep an eye on things". There is even some evidence that the very earliest forms of in situ breast cancer may actually be self limiting and if left would have disappeared as magically as they appeared. That is where the real research is taking place: how to spot them. I am utterly convinced someone would now spend even more words to advance the contrarian view. Just my 2 cents CB Quote Share this post Link to post Share on other sites
