<p>Thanks, Decorative.<br>
Breast cancer is not a simple disease with simple answers. If it were that clear cut, there would be no debate among experts as currently exists. There are always financial considerations from all sides, and research can be biased by drug companies, doctors, and governments. It’s hard to avoid, as so many have a stake in the outcome. And while statistics can be helpful, in the end they are very difficult to pull off free of bias.
Also good to remember that the numbers that make up the averages are real people with real disease, and what might look right statistically for the whole isn’t necessarily the best course of action for an individual. </p>
<p>That said, let’s find the cure for metastatic disease. Then it really won’t matter how early one’s cancer is detected. 40,000 Americans this year who will die of BC would like that, as well as the over 400,000 who will die this year, worldwide.</p>
<p>I’m sorry about your stage IV disease moonchild. As you said, there may have been a point in which a mammogram would have caught this early enough for you. A breast surgeon told me that for some breast cancers. it doesn’t matter when it’s found. In an interview I heard a couple of days ago from the lead researcher, he said lets focus our resources on treatment, non mammography.</p>
<p>moonchild - my prayers and well wishes for you as you face this. I will continue following up and being checked and your story is a reason why I won’t blow it off.</p>
<p>I cannot imagine how terrible it must be to live 25 years of your life with a cancer diagnosis that would never have been made nor made a difference in your life, but for a routine mammogram. Apparently that was the fate of 1 out of every 5 women diagnosed in the study. </p>
<p>I also appreciate moonchilds story very much. Thank you. </p>
<p>This study, “Disparities in the estimates of benefits and harms from mammography: Are the numbers really different?,” was presented on Dec. 11, 2013 at the 2013 San Antonio Breast Cancer Symposium. Study results also were published in the November 2013 issue of Breast Cancer Management. The article was titled “Real and artificial controversies in breast cancer screening.”</p>
<p>Just bringing this to you because some posters were not aware of the previous studies, many which have shown significant mammogram benefit. Again, my personal opinion is that there is a better way. I do think this study has some interesting things to say and perhaps explains why there is so much support in the medical community.</p>
<p>It’s difficult to argue with the conclusions of the study. One can argue that the randomization wasn’t done right-- that’s what the radiologists say-- but the study authors specifically claimed that the people doing the randomizing knew nothing about the health status of the participants, so one would have to bring forth evidence that the study authors are mistaken about their description to make this claim go through. Such evidence might exist, but the radiologists don’t offer any.</p>
<p>Various critics are also saying that the mammography machines are old-fashioned and don’t detect smaller cancers. But this line of argument doesn’t bite; it doesn’t make sense. The study is claiming that mammography is detecting a lot of cancers that never would have caused any problem, resulting in many women undergoing painful expensive treatment to cure a disease that wouldn’t have made them sick. But more sensitive machines would detect even more of these harmless cancers, and cause even more women to undergo useless treatment. More sensitive machines wouldn’t improve the situation; they would exacerbate the over-diagnosis and over-treatment.</p>
<p>When I hear a woman say that she had a cancer detected when it was small, and thank God isn’t it wonderful, she got treatment and she’s so grateful to her doctors, if she’d waited for it to become Stage 4 it would have been so bad, mammograms are wonderful!!!11eleven, I don’t say anything to her. But I think to myself, maybe if you’d waited until it became Stage 4, you would have been waiting until 2097. </p>
<p>Mine was palpable at about 2cm, but since I was in my 30’s there wasn’t a chance it would have been seen on the previous year’s mammogram since there weren’t any previous mammograms… So I fall into the “detected by BSE” category. Stage IIB.
If I had had been older and in the “screened by mammography” group would it have been caught earlier, before it spread to several lymph nodes and the sub-dermal tissues? Could I have been spared the intense chemo and the radiation (damage that is only now becoming evident 20 years later). Maybe, but of course it would be stupid to say everyone over 30needs an annual mammogram.
The harder question is how to advise my DDs.
Unfortunately I’m afraid they might sometimes skip the annual GYN visit and monthly BSE since they are young and invincible so I advocate for a baseline at 35 .</p>
<p>Dragonmom, sorry about the ravages. If you were older, likely it would have been a different kind of cancer, and waiting until it was palpable may not have been as much of a problem. The problem of mammography screening with premenopausal women is that the breasts are so dense the mammogram is not as sensitive and someone can’t have confidence of a negative result. The recommendation of your DDs may be to get genetic testing and possibly a breast MRI. </p>
<p>I think your recommendation is wise, dragonmom, considering your history. Most breast cancer cannot be explained through what they know of genetics at this point, so that probably won’t be helpful. If insurance would cover a breast MRI, that would be a good way to go. It’s unlikely they would cover it for screening, however, which might make the mammogram seem like an more reasonable choice to them. I don’t think I could talk my kid into paying thousands for an MRI when she could get a mammogram basically for free.
At this point I’m recommending the yearly manual exam for my Dd and mammogram at 40, and every other year after, unless something better has come along by then. (hope) My cancer was found at 56- probably began in my late 40s.<br>
Of course, this is predicated on the good luck that she has managed to avoid BC by the time she is 40.</p>