(05-01-2016, 12:44)spanky Wrote: I disagree. My wife is alive today because a mammogram caught a stage 1 breast cancer, and she is among many thousands of similar cases. Of course, mammography is not a perfect tool, but until something better is available, it is the best choice.
I don't know the specifics so I could well be wrong but the odds are your wife is alive today in spite of her treatment for this discovered "cancer" not because of the treatment. Read the following:
Abolishing Mammography Screening Programs? A View from the Swiss Medical Board
"Under normal circumstances, the Swiss Medical Board reported that for every breast-cancer death prevented in US women over a 10-year course of annual screening beginning at 50 years of age:
490 to 670 women are likely to have a false positive mammogram with repeat examination
70 to 100, an unnecessary biopsy
Three to 14, an over-diagnosed breast cancer that would never have become clinically apparent
This lack of clear benefit, and evidence of apparent harm, was enough for them to recommend abolishing mammography-screening programs."
The
Cochrane Collaboration was kind enough to put out a
Mammography screening leaflet in multiple languages outlining the science in layman's terms (find the English leaflet
available for download here.) The summary of the leaflet reads as follows:
"When we first published this leaflet in 2008, the Summary was:
"It may be reasonable to attend for breast cancer screening with mammography, but it may also be reasonable not to attend, as screening has both benefits and harms.
If 2000 women are screened regularly for 10 years, one will benefit from the screening, as she will avoid dying from breast cancer.
At the same time, 10 healthy women will, as a consequence, become cancer patients and will be treated unnecessarily. These women will have either a part of their breast or the whole breast removed, and they will often receive radiotherapy, and sometimes chemotherapy.
Furthermore, about 200 healthy women will experience a false alarm. The psychological strain until one knows whether or not it was cancer, and even afterwards, can be severe."
These numbers were derived from the randomised trials of mammography screening. However, since the trials were performed, treatment of breast cancer has improved considerably. More recent studies suggest that mammography screening may no longer be effective in reducing the risk of dying from breast cancer.
Screening produces patients with breast cancer from among healthy women who would never have developed symptoms of breast cancer. Treatment of these healthy women increases their risk of dying, e.g. from heart disease and cancer.
It therefore no longer seems beneficial to attend for breast cancer screening. In fact, by avoiding going to screening, a woman will lower her risk of getting a breast cancer diagnosis. However, despite this, some women might still wish to go to screening."
(05-01-2016, 21:46)spanky Wrote: Mammagrams have significant downsides, no doubt, and should not be overused. Still, together with self exam, they seem like the best alternative.
What does "should not be overused" even mean? Either they are beneficial or they're not. The fact that mammography is overused is the heart of the problem.
Self exam doesn't help either. Even the United States Preventive Services Task Force has stated, "The USPSTF recommends against teaching breast self-examination (BSE)." Specifically they say, "The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits." and that we should, "Discourage the use of this service."
