B C Charity Overstates Value of Mammograms: Res.

Also interesting to note coauthor of the article Woloshin, is also the coauthor of  book published in January, 2011 with the title  Overdiagnosed: Making People Sick in the Pursuit of Health, so he's definitely approaching the statistics  with a particular point of view.  Several have defended the use of mammograms for detection, as my bc was found on a mammogram, I'm more interested in what this doctor says, rather than what Woloshin ( not an oncologist, or surgeon):   "Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, supports the charity's push for breast cancer screening." Also influencing me, is the sense it's the women least able to afford it, with less access to regular screening, who would be most effected if it weren't made available for them.

What a load of rubbish. 

Im glad Dr Woloshin doesnt have any real power and personally I hope he never has. I had no suspicion whatsoever of having BC when I went along for my first mammo at age 42 just cause it was available for free. Had 3 large clusters of dcis found and am very happy to say that I was clearly overtreated with a masectomy (at least according to some). The wonderful overtreatment of my dcis via masectomy found 2 idc's and a micromet in a lymph on the outskirts of the initial lymph clearance. Think Id be in a world of hurt now nearly 4 years later if reports like this had received any validity and made me hesitate to have a mammogram. And what if I hadnt gone along at 42 for one? If Woloshin had his way I wouldnt have been popping in for one at 50 even if I was still alive as saving 7 out of 10000 women doesnt seem to be worthwhile to him.

Im curious as to what age of woman he would believe is worthy of saving?  I personally believe women from the age of 40 should be having mammograms every 2 years in the hope of detecting BC early as it does save lives. And who is going to act as god and decide at which age women's lives are no longer worth saving? Are  women 50 and over not worth saving because in his opinion they are only saving 7 in 10000? Would hate to be one of those poor 7 women not getting their mammos if that the case.

 What eactly does Woloshin want? Us to go back to the dark ages and not have mammos at all?  

 I dont know anything about Komen as Im an australian, but if they promote mammo's from the age of 40 then they are doing womenkind a big favour and should be applauded for their efforts. Unneccesary biopsies? Well Im proof that biopsies dont tell the whole story. If it did I would have simply had dcis only.

Many of us dislike the pinkification of BC, but you have to admit, its been effective and the word is out to women in most countries to get mammograms (generally from the age of 50) and there are plenty of women on these forus who can attest to the fact that early detection does save lives.

Editted to add no offence intended to other posters. We are all entitled to our own opinions. I just personally feel very strongly when aspersions are cast on the validity of early detection saving lives as you can tell lol.   Id rather overtreat the 10000 50 year olds so that the 7 allegedly with BC are saved or have their lives extended. 

Athena, I hate the "rah, rah, rah" crap too.  And I'm definitely not a fan of Ms. Brinker. 

But that doesn't mean that I have to disagree with everything that comes of out of Komen. Nor does it mean that I have to agree with everyone who speaks out against them.  

You say: "I disagree that he is presenting this either/or scenario or that he is privileging short-term anxiety over long term health problems. "  Okay, so tell me where Dr. Woloshin or anyone on the 'let's reduce the number of screening mammograms' bandwagon factors in the benefits of early detection in terms of reducing long term health problems.  Show me any discussions on this topic that mention any screening benefits other than the mortality figures.  And let me repeat the quote you included in your original post, "According to Woloshin's commentary, which appears online Aug. 2 in the BMJ, a woman in her 50s who goes for regular mammograms for 10 years will only cut her chance of dying by a fraction of a percentage point -- for very 10,000 women who are screened 7 deaths will be prevented."  How exactly is he not presenting this as a either/or scenario? It seems to me that's exactly what's he's doing.

I would actually be very interested in the discussion and would be much more open to the idea of reducing the frequency of screening mammograms if someone could show me that only a fraction of a percent of women benefit from earlier detection by being able to pass on more toxic treatments.  If 99% of women would get the same treatment regardless of when they were diagnosed, and if mortality rates barely differ, that's a much more compelling argument to suggest that the number and frequency of mammos could be reduced.  The problem is that nobody ever presents the data on the impact of early detection on treatment, and I suspect that if they did, it would make a compelling case in favor of maintaining or increasing the number and frequency of mammos (and other screenings). 

And yes, I do understand that statistics are for groups and not individuals.  But policy decisions that are made for groups end up affecting individuals.  It is disingenuous for anyone to push to change the screening policy or to argue against the societal value of screenings, but then to say that "every woman should make good decisions for herself".

Athena, I understood the study and the intent behind it which is why I responded here. To me Woloshin is treading in very dangerous waters, because Beesie, you and I and an unknown number of other women are living proof that early detection does save or extend lives. We wont know which applies to us until our autopsies which are hopefully not for another 50 years lol. If we die of something else, were our lives saved? If we die of BC in 20 years I guess its safe to say they were extended.  

In my eyes I guess what it comes down to Athena, are we better off knowing as early as possible as to whether we have BC or are we better off living our lives and then if and when we get sick, we die fairly quickly. Thats what I meant when I asked as to whether Woloshin wants us to to go back to the dark ages. There are probably plenty of women out there who dont want to know if they have something wrong with them, and those women most likely do not turn up every year or two for their mammo's and thats their choice and Im fine with that. But for the rest of the population who would want to know, early and regular screening is the only answer/hope we have.

I still dont know anything about Koman (and theres no need for me to learn because they do not operate in australia), but over here I think its safe to safe the average woman believes early detection MAY save their life or extend it. We all know there is no such thing as a cure at the present time. We are told to examine our breasts by the television ads and by our doctors and I doubt there is many women here that dont self examine on a fairly regular basis, just as a matter of course. We go along for mammos every 2 years with the hope that if BC developed between mammo's it would still be caught early enough to be a less aggressive form, but thats just a crapshoot as we all know. I know I went for my mammo without a care in the world and with no expectation of a call back.

When I was in my early 20's I remember having a philosophical discussion with my friends and we all said we'd rather not know and just die quickly if we had something wrong with us. (Im going to call that Option A and the equivelent of not screening regularly for the sake of this discussion.) Lmao, we were bullet proof back then. I also personally remember thinking 30 was ancient and hoped I never got that old and decrepit lol. Now at 46 I think 20 yo's are kids who have a hell of a lot to learn lmao. And as we have aged, my friends and I have discovered that life is precious and a gift and after I was dx'd those same friends lined up for mammos and thankfully were given the all clear. Our perspective on life changes over the years. Because of the widespread advice to women to self examine and have regular screening from a certain age, we can choose option B (screening) and are not stuck with our option A (not knowing till its too late). I hope that makes sense lol

What is the answer if we dont get screening early? Until medical science can work out exactly what causes cancer, mammos and us's are the only thing we have available for the average person like you and I who dont have a family history of BC or any of the known risk factors. And for you and I being in the same boat, theres another however many hundred thousand women just like us. Our cases are not unique.

Lastly I think its great that we can have this discussion without the vitriol that turns up so often when contraversial matters are discussed on these forums. I appreciate that we can offer our differing opinions without each of us attempting to bash the other into submission  

Apologies for the paragraphs being out of order. Cut and paste just isnt working for me and Im to lazy to retype everything lol