Papas Fritas writes:
"In the United States, about 37 million mammograms are performed annually at a cost of about $100 per mammogram and nearly three-quarters of women age 40 and over say they had a mammogram in the past year. Now the NYT reports that a study involving 90,000 women and lasting a quarter-century has added powerful new doubts about the value of the screening test for women of any age finding that the death rates from breast cancer and from all causes were the same in women who got mammograms and those who did not.
'It will make women uncomfortable, and they should be uncomfortable,' says screening expert Dr. Russell P. Harris who was not involved in the study. 'The decision to have a mammogram should not be a slam dunk.' An editorial accompanying the new study says that earlier studies that found mammograms helped women were done before the routine use of drugs like tamoxifen that sharply reduced the breast cancer death rate. In addition, many previous studies did not use the gold-standard methods of the clinical trial, randomly assigning women to be screened or not, noted the editorial's author, Dr. Mette Kalager. According to Kalager, with better treatments, like tamoxifen, it is less important to find cancers early.
Also, she says, women in the study were aware of breast cancer and its dangers, unlike women in earlier studies who were more likely to ignore lumps. 'As time goes by we do indeed need more efficient mechanisms to reconsider priorities and recommendations for mammography screening and other medical interventions,' concludes Kalager. 'This is not an easy task, because governments, research funders, scientists, and medical practitioners may have vested interests in continuing activities that are well established.'"
I spent all two and a half days completely freaked out, crying spontaneously, hyperventilating, waking up in a cold sweat at night, unable to focus on anything I'd had planned and a real drag on my whole family.
I realize this will come off as callous, but you're really not making me confident in our ability to have a reasonable, evidence-based discussion about this.
False positives are now known to take a serious toll, with the negative effects lasting quite some time. It's a non-negligible risk that must be weighed against the benefits of mammography. See here [annfammed.org], here [go.com], here [go.com] and here [ucsf.edu] for some data and discussion on the subject.
I'll go ahead and weigh in as another token. I, like the gp, have yet to undergo mammography, though I am considered "of an age", and will likely continue to postpone thanks to this research. I started getting nagged in my mid-thirties to begin annual mammograms, despite the recommendation at the time being to wait until after 40, and despite a lack of family history that would indicate I was at increased risk of breast cancer. I said, "No, thanks. I'll wait until I'm at least 40." Now I plan on waiting until I'm past 50. Every one is, of course, different and has a different family history and risk profile which must be taken into consideration when making such a decision. For me, the benefits of early/annual screening do not appear to outweigh the risks.
Did I mention the extensive family history of cancer? I lost my grandmother to uterine and colon cancer.
Yeah, I mean, really. Why can't she control her emotions and sleep well at night when she knows there is a higher than normal probability that she has cancer? I mean, even if it doesn't kill her, the treatment will probably only make her very sick where she's puking her guts up for weeks on end. Why would that upset her?
You want a reasonable discussion? You took her quote out of context. Just because she freaked about it then doesn't mean she can't have a reasonable conversation now. Finding out about cancer is a traumatic experience and the callous attitudes that many doctors and doctor's offices have about this just makes this whole thing awful. Even smart people with access to the Internet will have problems finding the right information about something as emotional and an informationally-dense topic as cancer.
I nearly broke when my best friend became a paraplegic a couple of years ago... and I had experience working with paraplegics professionally. I consider myself a reasonable guy with a lot of control on my emotions, but there are things than can strip me down, make me cry, and challenge my ability to have a reasonable discussion for a period of time. That doesn't mean I can't have a reasonable discussion about my friend or about paraplegia today and it doesn't mean that having a callous attitude is the best option when dealing with a person who needs help in a period of need.