This is old news.  Mammography doesn’t save many lives.  But no one is willing to discontinue using them.  PSA testing for prostate cancer is a similar testing dead-end.

What doctors need are more effective tests to take their places.  I believe several options are on the way.  But sometimes it isn’t just the test.  Sometimes early detection does more harm than good.  Both of these cancers are in that category, too.  It’s all very complicated, expensive and disappointing.

Did that mammogram really save Aunt Sally’s life?  She thinks it did–by detecting her cancer early.  But what if it hadn’t been detected?  Probably nothing.  Or it could have been discovered later and Sally would have been no worse for ware.

This ABC/AP article rehashes it all pretty well.  Here is enough to get you started:

Study Finds Mammograms Lead to Unneeded Treatment


November 22, 2012 (AP)

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don’t need treatment, the study suggests.

It’s the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call “cancer” are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don’t really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it’s relatively new to the debate over breast cancer screening.

“We’re coming to learn that some cancers — many cancers, depending on the organ — weren’t destined to cause death,” said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, “once a woman is diagnosed, it’s hard to say treatment is not necessary.”

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday’s New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it’s most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment…

CLICK HERE to read the rest of the article, and to access a number of video clips on the subject.  If you’re interested, I think you will find all of this worthwhile.
Feel good and keep smiling!  Pat

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