This story displays the vast gap between evidence and intuition.
Evidence was represented in this quote: "screening causes 10 times as many women to become cancer patients unnecessarily as it prevents from dying from breast cancer," says lead author Karsten Jorgensen, a researcher at the Nordic Cochrane Centre in Copenhagen.
Intuition takes over in this quote:
But Elizabeth Thompson, vice president of health sciences at Susan G. Komen for the Cure, a breast cancer advocacy group based in Dallas, says she worries that these studies will undermine her group's awareness efforts.
"I don't think you can say that we're overtreating those women. We know that some of these cancers become invasive," she says. "We need to keep hammering away at our basic message, which is, early detection saves lives."
Yet, the next line of the story reveals what appears to be a difference of opinion with the Komen organization:
Dr. Eric Winer, director of the breast oncology center at the Dana-Farber Cancer Institute and chief scientific advisor for Susan G. Komen for the Cure acknowledges that messages about mammography may need revamping.
"As painful as it is to admit, we have oversold mammography to the American public," he says. "Frankly, I don't know what to do with this. On the one hand, I don't want to push people away from mammography, but I don't want to encourage them to have misconceptions about mammograms either."
It's interesting that this is only coming up now. A little over 20 years ago, when I was living in Ireland, I had the good fortune to meet Dr Petr Skrabanek, who was (among many other things) an early critic of mammogram screening. I think people's initial reactions to his opposition to screening were always shock and disagreement, but anyone who took the time to understand what he was actually sasying could undertand that he actually had an intelligent point.
(See for example http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1835201&pageindex=1).)
But as against that, so many of us know women who've had breast cancer, many of those diagnosed via mammogram. It's very hard to argue when a good friend looks you in the eye, tells you she's had cancer, and begs you to "get the mammogram done". In statistics vs. emotion, emotion wins every time.
wg
wg
Hi Gary,
I enjoyed reading your article, which I accessed through Medpedia (I am also a member on this site).
I am a breast cancer survivor whose tumor was missed by a mammogram. I found my own tumor through one of my routine breast exams at home. My breast tissue was dense, as I was younger, thus causing a mammogram to miss it.
I believe mammograms are useful and better than nothing, but I do think MRIs and other diagnostic tools are better. For that reason, my oncologist had me get an MRI each year after my treatment ended. Almost four years ago, an MRI caught something a mammogram would've missed. While it turned out to be scar tissue, I had a preventive mastectomy with DIEP flap reconstruction.
Turns out, a biopsy revealed I had precancerous cells. Had it not been for the MRI catching a subtle benign problem, I would've had a recurrence that would've once again been missed by a mammogram.
Thank you once again for an informative posting.
-- Beth L. Gainer