Mammograms and breast cancer

A 25 year study does not take into account the advances in treatment - they didn't have Herceptin 25 years ago. I consider my self to be lucky, in that ILC does often NOT show up on mammos until it is really large - I could be one of the dead ones if not for that mammogram. It certainly was not palpable. The only way to determine a lump is likely to never have caused death is to find it and biopsy it. Good luck on finding a lot of lumps without a mammogram.

Good news: It's so rewarding to see that the actual data.

Bad news: the data shows no lives have been saved by screening mammograms.

The Scandanavians found this out a few years ago when they studied women who had mammograms every five years had less cancer than the yearly screeners. A different way of studying mammos--but a poor patient outcome for yearly screening.

Understandably, it will take time for those of us who relied on screening mammos to accept the fact that the experiment failed.

No, Lucy, what the new study is saying is that the current “one size fits all” regimen is probably too aggressive for most women at average risk for breast cancer.  For those of us who are at high risk for breast cancer or breast cancer recurrence, the consensus still seems to be that the benefits outweigh the risks of annual screening, and - for women over 60 - saves lives.

"Bad news: the data shows no lives have been saved by screening mammograms."

NO, Lucy.

You cannot draw that conclusion.  

Why do you keep insisting on interpreting the research incorrectly?

As the authors said, the mortality results between the two groups were "similar".  This does not mean that no lives were saved.  The only thing we know is that mammograms did not save enough lives to drive a 95% statistically significant difference.  When you are looking at a group of tens of thousands women, you can have differences in the tens or even hundreds that are not "statistically significant".  

The actual study results, as I have pointed out before, showed that the mortality rate was 108.4 per 10,000 women in the mammogram group, and 110.2 per 10,000 women in the control (i.e. the non-mammogram) group.  So in this particular study, it appears that a few lives may in fact have been saved among the women in the mammogram group, but there were not enough saved lives to suggest that this would be the result that we would see other studies.  In other words, while the result might be real, it might be random.  It's impossible to know.  And if a result can't be certain to be repeated in at least 95% of other similar studies (i.e. a 95% chance that the result was not random), then the result is not considered valid.  And that's why the conclusion is that there is no significant difference in mortality rates between the two groups.  But the data in this study most certainly did not show that no lives were saved.  That conclusion cannot be reached.

Lucy, if you don't understand how to interpret research, please don't quote it (or more to the point, misquote it). 

Do you not understand that you can't use research to draw absolute
conclusions ("no lives saved")?  Research provides only relative results.

And do you not understand that in research
you cannot assume that the null hypothesis is true just because the research hypothesis has not been proven? 

In research, when you are comparing two things or groups, the research
hypothesis is the position that says that there is a difference.  The null
hypothesis is the default position, the position that suggests that there is
no difference between these two things or groups. If you prove a research hypothesis to be true, you thereby disprove the null hypothesis. But not being able to prove a difference (i.e prove that the research hypothesis is true) doesn't prove (although it may imply or suggest) that there is no difference (i.e. that the null hypothesis is true).

"...if you want to prove that a treatment has an effect, you start by
assuming there are no treatment effects—this is the null hypothesis.... The idea of a hypothesis test is to assume the null is true, then use
that assumption to build a contradiction against it being true.... No conclusion can be drawn if you fail to build a contradiction....lack of evidence to reject the null does not imply sufficient evidence
to support it. Absence of evidence is not evidence of absence. Some
would like to believe that the inability to reject the null suggests the null may be true... Failing to reject the null is a weak outcome..." You can’t prove the null by not rejecting it

That said, from a practical standpoint, if over time there are enough instances where research is done that fails to disprove a particular null hypothesis, the null hypothesis does become closer to being "proven" to be true.  But you shouldn't draw definitive conclusions about a null hypothesis from one study, as too many are attempting to do with this particular study. 

"Understandably, it will take time for those of us who relied on screening mammos to accept the fact that the experiment failed."  Personally, I'm taking you on about your misinterpretation of the research itself, and the fact that you are drawing erroneous conclusions. I am not arguing for or against screening mammograms. 

Edited for typos only (I shouldn't start writing posts when I'm in a rush!)

Carol, indeed you do as learning how to analyze research is a university level  course.  I took one class on statistics for a social work degree and it was by far the most challenging class for me.  All I gained from that class was the knowledge of how easy it is for studies to show results that they want to show and if you do not know how to critically analyze the research design and results, the average person would simply accept those findings as stated.  I am now so nervous to accept studies at face value. 

I am now letting Beesie and the other knowledgeable women do it for me.  You are more ambitious than me!  Good luck

In Australia you get a screening mammo free every 2 years if you are over 45.

Thermography certainly does not sound all that accurate - glad I haven't fallen for that one.

As has been pointed out above, breast thermography is not recommended as a reliable substitute for mammograms at this time because it's inaccuracy rate is far greater than mammograms.  In future, if breast thermography technology improves and its accuracy rate gets better, the issue may be revisited, but - right now - thermography just doesn't have the same science-based results that mammograms do. 

What scares me the most about the wilfull (or uneducated) misinterpretation of this study in the media is that insurance companies will jump on it as an excuse to quit funding screening mammograms no matter what a woman's risk is.  That's why it's so important for everyone to truly understand what the study is saying and what it is not saying.  Beesie's explanation above is one of the best I've seen regarding what the data actually says about this issue. 

Fallleaves... I think it's because a mammogram, an ultrasound and an MRI provide different levels of information in the screening process.  Once you've had a baseline mammogram done, a screening mammogram helps determine if there are any changes in the breast since either the last mammogram or the baseline.  At this point, if nothing new seems to be developing - and a clinical breast exam reveals nothing of concern - the screening process stops here, but - if "something" is detected - an ultrasound is the next step.

An ultrasound will indicate if the "something" is solid or cystic.  If cystic, then the issue is dealt with and the screening process stops here.  If it's solid, then the next usual step is a biopsy to determine if the "something" is benign or malignant.  If it's benign, the screening process stops, if it's malignant further diagnostic tests (MRI/CT, bone scan, etc.) are, then, done to determine the extent of disease. 

This three-pronged approach is the standard of care in Ontario.  While each test reveals different information - the mammogram reveals if there is "something", the ultrasound reveals what the "something" is comprised of, and an MRI/CT/bone scan reveals the extent of the "something" - taken all together one gets a fairly good idea of what one is dealing with and - based on the combination of results - the type of surgical intervention is decided.

Unfortunately, there isn't a single test (yet) that can replace all these and, until there is, I imagine that all of them will continue to be used until something better- and more accurate is developed.

gary null now talking about black plum leaf extract to protect against radiation

No problem fallleaves!

leia, I am sorry you see it that way. I for one, don't judge you for your choices, but I don't think "Moronic" was the best choice of word for how you feel about the method that most of us have used and in fact were actually dx with.

I think that, was really what inflamed this thread, not the subject matter. 

Many of us here have investigated the alternatives available, and many have integrated alternative therapies, along with our other treatments and imaging choices. It is all entirely individual choices and you'll never find everyone agrees, on any one thing. You can see there were many here, myself included, who investigated thermography and found it just wasn't right for them, but if you are happy with those figures and the reduced radiation, all power to you.  You should do what your heart tells you.

Just because some happen to disagree on this imaging method, isn't a slight against you as an individual. You certainly aren't the first to bring up either Thermography or the Mammogram Study on these boards.

The one thing that is always consistent here, is that we are all different, but similar. No one goes into any of this lightly, all we can do is hope that we have made choices that will give the best outcome for us and our families.

I wish you all the best with your choices!

I agree it will be great when there is no condemning of others on this site for their choices. I think everyone now knows what it is like to be on the receiving end of that. I think it would be great if we were all conscientious enough to be careful about how we say things, on all the threads, in order to be good examples for how we wish to be and really need to be and deserve to be treated...now more than ever. 

I agree with what Ariom said about why the choice of words may have invited an argument. We all want a place a thread where we can "reserve the right to voice our opinions". For Alt gals, the Alt forum is the only place they have. Seems we need to come to an agreement that we can stand by together, that all threads should steer clear of stating opinions in a way that may be hurtful, or obviously offensive to another. We can instead  choose to have sensitivity to others who may not agree, rather than assume that "snarky"  which is not sensitive, is acceptable. Provocative, ridiculing comments and photos about others and their choices should also be discouraged, rather than encouraged, on all forums, yes?

Someone else had mentioned that the mammo argument has reached "war" level out there. Clearly there is much more to be learned about what is safest and best practice for screening as well as treatment, so right now, no one is right or wrong and again we are arguing a matter of preference, or assuming that what works for some should work for all.

For me, my breasts tissue was always too dense for mammos to read. My tumor was found by me and the ultrasound was able to provide sufficient imaging. Some women do not have dense breast tissue and it seems mammos work best at detection for these women, but because dense breast tissue is such a culprit among risk factors for bc, I too feel it is imperative to find a better imaging tool, ideally one that does the job, for all, and is proven to be safe.