Follow Us Here:

Cancer Knowledge Network

Cancer Knowledge Network and Current Oncology are proudly published by Multimed Inc.
0
Menu
The Oncologist, the Patient and CKN — Sharing Knowledge

Tag Archives: mammogram

Breast Cancer Screening, Mammography and “Alternative Facts”

Mammography

 

 

Some types of screening are a good idea colorectal, for example,said the lead author, Dr. Karsten Juhl Jorgensen, deputy director of the Nordic Cochrane Center. But breast cancer has a biology that doesnt lend itself to screening. Healthy women get a breast cancer diagnosis, and this has serious psychological consequences and well-known physical harms from unnecessary treatment. Were really doing more harm than good.”  The New York Times The Downside of Breast Cancer Screening

After reading the above NYT article, we wanted to explore both sides of the Breast Cancer Screening debate so we invited professionals and patients to weigh in with their opinions.  We believe patients should be informed before making health care decisions and that includes reading evidence-based research reports as well as hearing personal narratives from patients who have gone through similar experiences.

Our intention with this series is to inform our readers about the facts surrounding breast cancer screening and the implications toward informed decision making.

 

Continue reading

Breast Cancer Screening Series: Dr. Daniel Kopans

Daniel Kopansby Daniel B. Kopans, M.D., F.A.C.R., F.S.B.I, Professor of Radiology Harvard Medical School, Founder – Breast Imaging Division – Massachusetts General Hospital

“ALTERNATIVE FACTS” AND BREAST CANCER SCREENING

 

“Alternative Facts” (AF) recently appeared as an outrageous concept in the “political arena”. What most do not realize is that “alternative” facts have been promulgated for decades by those seeking to reduce access to breast cancer screening.  This has led to the pseudo “debate” about screening that has persisted for decades due to the “alternative facts” that have been manufactured to keep the “debate” going.  Each time an “alternative fact” has been generated to cast doubt on screening, it has been refuted by science ([i]).  Unfortunately, as each (true) fact has been established, new “alternative facts” have been manufactured.  The article in the Annals of Internal Medicine cited by Nicholas Bakalar in the New York Times is an example of misinformation that got past poor peer review at a major journal and was published despite its lack of scientific rigor.  The study from Norway ([ii]), cited by Mr. Bakalar ([iii]), claiming massive “overdiagnosis” due to mammography had no data on who actually had mammograms and no data on which cancers were detected by mammography.  How can a test (mammography) be faulted when the “investigators” had no information on who actually had the test?  In an earlier, scientifically more rigorous study from Denmark, Njor, et al looked at actual individual patient data and they found that there was little if any “overdiagnosis” due to screening ([iv])  and, another study found, contrary to the conclusions of the paper reviewed by Bakalar, that screening had in fact resulted in a marked decline in deaths from breast cancer in Denmark ([v]).

 

Continue reading

Breast Cancer Screening Series: Khevin Barnes

KhevinBarnes4by Khevin Barnes, Breast Cancer Survivor

 

I remember the very moment my primary care physician announced that he was scheduling me for a mammogram.  It was May 3rd, 2014.  I watched the expression on his face as he told me this, hoping to discover some faint smile to indicate that he was joking with me. I looked at him incredulously, not quite understanding the words he had just spoken.  I waited for the punchline.  There wasn’t any.

 

Continue reading

Breast cancer screening panels continue to confuse the facts and inject their own biases

breastcancerby D.B. Kopans, MD, Breast Imaging Division, Department of Radiology, Massachusetts General Hospital, Avon Comprehensive Breast Center, Boston

Perspectives in Oncology, originally printed in Current Oncology 

 

Additional confusion has been added to the “debate” about breast cancer. Women, their doctors, and the media are being misled, and women will die, unnecessarily, as a result. I recently outlined the scientific errors that I was concerned would be made by the U.S. Preventive Services Task Force (USPSTF) and the International Agency for Research on Cancer (IARC) panels in their reviews of breast cancer screening guidelines. Based on the draft proposal by the USPSTF, and now IARC, my concerns have been realized. Because the panels include few (if any) experts in screening, they are unable to sort out the validity of the various analyses involved, and they give credibility to analyses that have major flaws.

One of the other major problems with the panels is that their deliberations are held in secret. If anything should be completely transparent, it should be discussions of health care guidelines. It is my understanding that the IARC panel did not unanimously agree, and that a number of panel members felt that the data supported screening women starting at the age of 40. There should be transparency, and IARC should provide full disclosure, as well as any minority reports.

Continue Reading….


Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial

Mammogram2Abstract

Objective To compare breast cancer incidence and mortality up to 25 years in women aged 40-59 who did or did not undergo mammography screening.

Design

Follow-up of randomised screening trial by centre coordinators, the study’s central office, and linkage to cancer registries and vital statistics databases.

Setting

15 screening centres in six Canadian provinces,1980-85 (Nova Scotia, Quebec, Ontario, Manitoba, Alberta, and British Columbia).

Participants

89 835 women, aged 40-59, randomly assigned to mammography (five annual mammography screens) or control (no mammography).

Interventions

Women aged 40-49 in the mammography arm and all women aged 50-59 in both arms received annual physical breast examinations. Women aged 40-49 in the control arm received a single examination followed by usual care in the community.

Main outcome measure

Deaths from breast cancer.

Results

During the five year screening period, 666 invasive breast cancers were diagnosed in the mammography arm (n=44 925 participants) and 524 in the controls (n=44 910), and of these, 180 women in the mammography arm and 171 women in the control arm died of breast cancer during the 25 year follow-up period. The overall hazard ratio for death from breast cancer diagnosed during the screening period associated with mammography was 1.05 (95% confidence interval 0.85 to 1.30). The findings for women aged 40-49 and 50-59 were almost identical. During the entire study period, 3250 women in the mammography arm and 3133 in the control arm had a diagnosis of breast cancer, and 500 and 505, respectively, died of breast cancer. Thus the cumulative mortality from breast cancer was similar between women in the mammography arm and in the control arm (hazard ratio 0.99, 95% confidence interval 0.88 to 1.12). After 15 years of follow-up a residual excess of 106 cancers was observed in the mammography arm, attributable to over-diagnosis.

Conclusion

Annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available. Overall, 22% (106/484) of screen detected invasive breast cancers were over-diagnosed, representing one over-diagnosed breast cancer for every 424 women who received mammography screening in the trial.
Read the Article

 

Related CKN Content:

Breast Cancer Screening in BRCA1/2 Carriers

Pink Ribbons, Inc

 

Breast Cancer Screening in BRCA1/2 Carriers

by Rosanna Grobbink, B.Sc, ND (Cand)

As practitioners with a special interest in the prevention of disease, naturopathic oncologists often are asked by patients to discuss the topic of potential risks involved with various types of diagnostics.  A common concern of a patient is the long term effect of radiation emitting imaging.  This is especially a concern if the imaging must be repeated frequently.

Continue reading