Mammograms and Early Detection and PInk Ribbons
As many of you know, I can never pass up an opportunity to be critical of the Pink Ribbon Breast Cancer World. It offends me in all manner of ways, but one of the central ones is the absolute hypocrisy of many sponsors, and the misinformation that is foisted onto the world. "Early detection and you will be cured" is the message, and that is just not necessarily true. This all ties into the controversy about screening, most specifically about the value of mammograms.
This is an especially excellent piece from the New York Times about these interconnected issues. I give you an excerpt and a very strong recommendation to take a few minutes to read it:
Our Feel-Good War on Breast Cancer
By PEGGY ORENSTEIN
Sixteen years later, my thinking has changed. As study after study revealed the limits of screening — and the dangers of overtreatment — a thought niggled at my consciousness. How much had my mammogram really mattered? Would the outcome have been the same had I bumped into the cancer on my own years later? It’s hard to argue with a good result. After all, I am alive and grateful to be here. But I’ve watched friends whose breast cancers were detected “early” die anyway. I’ve sweated out what blessedly turned out to be false alarms with many others.
Recently, a survey of three decades of screening published in November in The New England Journal of Medicine found that mammography’s impact is decidedly mixed: it does reduce, by a small percentage, the number of women who are told they have late-stage cancer, but it is far more likely to result in overdiagnosis and unnecessary treatment, including surgery, weeks of radiation and potentially toxic drugs. And yet, mammography remains an unquestioned pillar of the pink-ribbon awareness movement. Just about everywhere I go — the supermarket, the dry cleaner, the gym, the gas pump, the movie theater, the airport, the florist, the bank, the mall — I see posters proclaiming that “early detection is the best protection” and “mammograms save lives.” But how many lives, exactly, are being “saved,” under what circumstances and at what cost? Raising the public profile of breast cancer, a disease once spoken of only in whispers, was at one time critically important, as was emphasizing the benefits of screening. But there are unintended consequences to ever-greater “awareness” —and they, too, affect women’s health.
4/25/2013 8:06 PM
If you are one of the woman where only the mammogram was able to detect their early stage aggressive form of breast cancer, you would feel good about getting your yearly mammogram. I am one of the small percentage of woman whose life was possibly spared because my cancer was detected early (Her2+ Er- PR-) and I am 3 years cancer free.