Posted on 02/16/2014 12:50:25 PM PST by Kaslin
In 1999, newspaper columnist Molly Ivins was diagnosed with breast cancer and promptly exhorted her readers: "Go. Get. The. Damn. Mammogram. Done."
She also quoted a friend, columnist Marlyn Schwartz, who lamented, "If you have ever wondered what it would feel like to sit in a doctor's office with a lump in your breast trying to remember when you last had a mammogram, I can tell you. You feel like a fool."
Ivins' breast cancer killed her in 2007. She didn't say whether she had gotten regular mammograms before her diagnosis. If so, she was spared something many a dying breast cancer victim has endured: profound, awful regret at failing to undergo a procedure that would have saved her life.
It turns out now that this kind of regret is misplaced. Mammograms, as administered in advanced nations, do not save lives. Get one done, don't get one done -- either decision is very unlikely to affect your lifespan.
That's the verdict of Canadian medical researchers who followed thousands of women over 25 years and published their results in the British Medical Journal this past week. "Annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care," they found. An accompanying editorial carried the headline: "Too much mammography."
Mammograms do detect some cancers that can't be felt in a physical exam, and some of these are life-threatening. So how come finding some cancers earlier doesn't save lives? Two reasons: Most instances of breast cancer can be successfully treated even when caught later, and some can't be successfully treated even when caught early.
The proliferation of mammography has coincided with a decline in breast cancer deaths, which gives the impression that the former caused the latter. In truth, improved survival rates stem mostly from improved treatments.
With regard to routine mammogram screening, H. Gilbert Welch, a physician and professor at the Geisel School of Medicine at Dartmouth, told me, "I genuinely believe that some women are helped, but the number is very small and getting smaller."
Mortality aside, early detection sometimes spares women aggressive treatments they would require if they were diagnosed later. But more often, it subjects patients to surgery and other measures they don't need.
If this process helped only a few women while doing nothing for the others, it would be easy to justify. The problem is that it harms far more women than it helps.
In a recent article in the Journal of the American Medical Association, Welch and Geisel colleague Honor J. Passow calculated that for every 50-year-old woman who avoids death from breast cancer through annual mammograms, at least 153 (and likely far more) suffer false alarms and at least four are "treated needlessly with surgery, radiation and/or chemotherapy."
In fact, over a decade of annual screenings, half or more of patients will be the victims of false positives that at best induce anxiety and at worst require surgery or other treatments for cancers that would not harm them. "My value judgment is that a population-based screening program that alarms half the population is outrageous," says Welch.
The point is not that the mass of American women should avoid annual mammograms. It's that they shouldn't do them without understanding that the procedure carries a small prospect of a large benefit and a large prospect of a small harm.
Women are not the only people who face this sort of dilemma. A widespread test for prostate cancer works almost identically. It detects a lot of cancers that are either unlikely to be fatal without treatment or very likely to be fatal even with treatment, while exposing many men to needless fear as well as treatments with serious side effects. The U.S. Preventive Services Task Force now recommends against it for routine screening.
Annual mammograms for breast cancer are expensive. Putting every woman through it annually starting at age 40 would cost a total of $10 billion a year. Starting the screenings at age 50 and doing them every other year until age 69 would cost $8 billion a year.
That's about twice what the government's National Cancer Institute spends annually on cancer research. Money spent on mammograms could be used in ways that would save more lives.
How should we feel about a health care system that has long put so much faith in such a flawed instrument? At least a little foolish.
http://www.youtube.com/watch?v=wvzDHGLEUyw
http://www.youtube.com/watch?v=givgNbs8amE
http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Daps&field-keywords=gerson+diet
Since I heard about this years ago, and my wife recently acquired a friend who was cured of stage 4 cancer just last year through this treatment alone, I have even less respect for the pink ribbon than I used to.
It costs an average of $850,000 to die of cancer in the US. Or you can survive for almost nothing.
Good to know. I’ve spent most of the past thirty years feeling guilty about not doing mammograms or at least not very often. I’ve maybe had five and I’m 66. Regular breast exams however I think are good. Once a week and then my regular doc and my gynecologist each do one so that’s two or three times a year. Instead, do the colonopthingie. My docs also want me to do bone density testing but when we talk about what they would do if I had issues, they admit that the course of meds and supplements I take now would stay the same. Try to do 30 minutes of exercise per day (and if you try daily you’ll succeed about 5 times a week) and eat well. Do all that and you’ll die some day. LOL
My understanding is this research is seriously flawed. Given that this comes out of Canada ....
All I know is that a mammogram my wife had after our last son in April showed a very small lump in a milk duct. A biopsy later showed a malignancy that we quickly treated with surgery to remove her breast. She had reconstructive surgery and is cancer free. Early detection saved her much pain from radiation and chemotherapy.
That mammogram saved my 42 year old wife and mother to my five children. Get your mammogram. It is painless and paid for by insurance.
This is more propaganda to limit the cost of health care to those countries with government funded health care. Dead people don’t need health care and subsequently give a large chunk of their estate to the government.
If you like your boobies, you can keep your boobies.
You’re saying that they started this study 25 years ago to create propaganda for 0bamaCare?
The five-year survival rates for all forms of breast cancer in the US is 85 per cent. However in the UK with their socialized medicine system five year survival is under 74 per cent. In the UK their socialized medicine system allows mammograms every three years and don't start until age 50 compared to annual mammograms starting at age 40 in the US. If the breast cancer is caught early (stage 1) an American woman has a 97 per cent chance of being alive five years after diagnosis. In Britain with their socialized medicine system, five year survival for stage 1 breast cancer is only 78 per cent.
I fear these studies will be used by Obamacare bean counters to stop annual mammograms by saying see it doesn't make any difference in this large study, but ignore the details and the very high rates of survival and early rates of detection under our current system.
Cuban leaf, Gerson is a crank and has cured nothing.
Yes, you can cure a lot of stuff by plain old fasting and praying and I wouldn’t give one thin dime to the medical professions cancer “cures”
I can remember having a conversation 25 years ago concerning the use of percentages while developing hospital policies. What test we did , how often we did them all seemed to depend on the “percentages of positive outcomes”. Unfortunately, according to the administration, some patients would fall through the cracks.
The meme for men and women has been to push off cancer screening another 5-10 years. Canada has its own socialized medicine, doesn’t need to do this just to prop up Obamacare.
Many women with fibrocystic breasts get false positives with mammograms. They should also have a sonogram. Certain ethnic groups are especially susceptible to aggressive breast cancers prior to the age of 40. They would be dead if they waited to get mammograms until 50. I think that women should be allowed to get a “baseline” mammogram at any age, especially if there’s a family history. Actually, I’ve paid for several mammograms out of my own pocket, because I had a skin cancer on my breast, and I didn’t want the government telling me when I’m “allowed” to have a mammogram.
My mother died because she had a normal mammogram. Her doctor told her she could stop worrying about the lump in her breast because the test was normal.
We know that the mammogram helps some and does some harm to others. What we should be doing is figuring out how to identify the two groups.
What I know is that the efficacy of mammograms was never in question ... until we were faced with ObeyMeCare. About a year before it was finally signed we started hearing, oh, nobody really needs one yearly.... oh, 40 year olds should just wait til they’re 50 for a baseline.... oh, maybe insurance companies should drop coverage for annual screens...
All ju$t coinkydink, I’m $ure.
“That mammogram saved my 42 year old wife and mother to my five children. Get your mammogram. It is painless and paid for by insurance.”
whoa. Skippy, whatever mammography is —it is FAR from “painless.” I want you to strip naked. Now, put your “member” on a flat surface. Next, take a large book and put it over your “member.” Next lean on that book as hard as you can for a few minutes, then get back to us how “painless” that is.
“That mammogram saved my 42 year old wife and mother to my five children. Get your mammogram. It is painless and paid for by insurance.”
whoa. Skippy, whatever mammography is —it is FAR from “painless.” I want you to strip naked. Now, put your “member” on a flat surface. Next, take a large book and put it over your “member.” Next lean on that book as hard as you can for a few minutes, then get back to us how “painless” that is.
Standard mammo couldn’t detect my wife’s lump ultrasound did only other option would have been MRI - we biopsied off the ultrasound and are now 9 years from the event.
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I had one who told me ovarian cysts were normal and I should quit complaining about the pain.
I went to another doctor. He had me in surgery in six weeks.
Too much damage had been done by my prior doc's cranial rectal inversion to be totally corrected but at least I didn't die.
Pap tests are only needed every two years now and PSAs are not useful. Recommendations for Colonoscopies are morphing too. IMHO it has everything to do with the cost.
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