“Therefore, mammographic screening cannot account for most of the reductions in breast cancer mortality that have occurred in Australian women since 1991 and may have contributed to over-diagnosis. Most, if not all, of the reductions can be attributed to the adjuvant hormonal and chemotherapy, which Australian women have increasingly received since 1986.”
http://www.ncbi.nlm.nih.gov/pubmed/21956213
Was this one for me, poikilotherm?
;)
Ah, just had a look. I thought I’d read it before. It was published earlier this year.
buffy said:
Ah, just had a look. I thought I’d read it before. It was published earlier this year.
I must have missed it…
“mammographic screening cannot account for most of the reductions in breast cancer mortality that have occurred in Australian women since 1991 and may have contributed to over-diagnosis.”
Of course, there are also the false negatives to be taken into account. The ones where they have already referred their monthly quota of “Hmm… you may want to get that checked out” to the relevant specialists, leaving the patient blissfully aware that they may already have breast cancer.
What about increased awareness and women getting checked out before the cancer becomes a problem?
I believe you sciency people call it “earlier diagnosis”.
>I believe you sciency people call it “earlier diagnosis”.
Us engineers call it “preventative maintenance”.
:)
Divine Angel said:
What about increased awareness and women getting checked out before the cancer becomes a problem?
Like this?
“Women aged 40-49 years, who had the lowest BreastScreen participation (approximately 20%), had the largest mortality reduction”
sibeen said:
>I believe you sciency people call it “earlier diagnosis”.Us engineers call it “preventative maintenance”.
:)
“Women aged 60-69 years, who had the highest BreastScreen participation (approximately 60%), had the smallest mortality reduction”
“Women aged 60-69 years, who had the highest BreastScreen participation (approximately 60%), had the smallest mortality reduction”
Could that be because the women in that group have a family history, and are therefore more likely to be examined but also more likely to die from the disease.
sibeen said:
“Women aged 60-69 years, who had the highest BreastScreen participation (approximately 60%), had the smallest mortality reduction”Could that be because the women in that group have a family history, and are therefore more likely to be examined but also more likely to die from the disease.
That’s some history…that age group was specifically targeted with TV ads and mail outs to participate in screening.
sibeen said:
“Women aged 60-69 years, who had the highest BreastScreen participation (approximately 60%), had the smallest mortality reduction”Could that be because the women in that group have a family history, and are therefore more likely to be examined but also more likely to die from the disease.
Women in that age bracket get free breast screening too. Young ‘uns have to pay for it, and often need an ultrasound to screen.
Actually, I misread what it was saying.
Realistically isn’t it saying, to paraphrase, “you’re old, you die”.
Not exactly earth shattering news.
sibeen said:
Actually, I misread what it was saying.Realistically isn’t it saying, to paraphrase, “you’re old, you die”.
Not exactly earth shattering news.
Well, I think it’s also saying, you’re old, there’s no point taking part in screening (tax funded…), as it doesn’t change your outcome (death) compared to normal diagnosis methods and chemotherapy etc.
Divine Angel said:
What about increased awareness and women getting checked out before the cancer becomes a problem?
Anecdote alert!
A work colleague of Spiderlily’s had a mastectomy a couple of months after a breast screen. The records of the screen revealed a shadow that later became the cancer. The Doctor claimed that it should have been mentioned as something that needed checking, but apparently the public screening doesn’t do a very good job with that end.
poikilotherm said:
“Women aged 40-49 years, who had the lowest BreastScreen participation (approximately 20%), had the largest mortality reduction”
Hehee. You make it sound like the scans are killing them.
MaternalGrandmotherRule had a double mastectomy at age 26. Both breasts, the muscles under them and the lymph nodes next to them. MumRule had 45 years of believing she was at elevated risk of breast cancer before BigSisRule went through the process to get it checked properly. According to MaternalGrandmotherRule’s medical records, they found nothing but normal tissue.
So, yeah…. False positives can be bad shit.
:-(
Was the done thing in those days for breast cancer (total mastectomy) for GranRule. Was only questioned re efficacy in ~1968 (surgery developed/popularised in 1894).
Yes….but from the anecdote as given so far by Rule….no-one bothered to say “oops” or let the patient know the results afterwards.
Which also means you would never know how many really weren’t what they might have been. Because it would be very, very difficult in an age of litigation, to be able to come clean about such things.
buffy said:
Yes….but from the anecdote as given so far by Rule….no-one bothered to say “oops” or let the patient know the results afterwards.
That was back in the day (assumed given my guesstimate of Rules age) when your medication came with ‘The Tablets’ or ‘The Mixture’ etc. written on them, no other information apart from dosing…so it’s unsurprising.
Yes, perhaps I was too obtuse. I know we expect more info now than even 40 years ago. But even now, if a lesion turned out to be non malignant, would you be told, after the surgery had been done? Wouldn’t that invite litigation?
There is also some recent research showing that some breast lumps actually just disappear given time. But we are in a place medically that can’t afford to wait and see.
Watchful waiting is no longer practised a lot.
I had a parotid tumour when I was about 21 or so. The (expensive) doctor looked at it carefully every six months for three years before he whipped it out. After the massive operation he said it was benign, but still wanted to see me 6-monthly for 5 years.
Michael V said:
I had a parotid tumour when I was about 21 or so. The (expensive) doctor looked at it carefully every six months for three years before he whipped it out. After the massive operation he said it was benign, but still wanted to see me 6-monthly for 5 years.
at least you were monitored well.
Michael V said:
I had a parotid tumour when I was about 21 or so. The (expensive) doctor looked at it carefully every six months for three years before he whipped it out. After the massive operation he said it was benign, but still wanted to see me 6-monthly for 5 years.
My missus had a benign melanoma removed about three and bit years ago… she had to get a check up every three months for the first two years and is now on 6 monthly check ups…
diddly-squat said:
Michael V said:
I had a parotid tumour when I was about 21 or so. The (expensive) doctor looked at it carefully every six months for three years before he whipped it out. After the massive operation he said it was benign, but still wanted to see me 6-monthly for 5 years.
My missus had a benign melanoma removed about three and bit years ago… she had to get a check up every three months for the first two years and is now on 6 monthly check ups…
my missus has had lumpectomies and has SCC’s removed often. Her mother has had a mascetomy and her sister has had a malignant tumor removed from her breast plus removal of the signal lymph glands and a malignant melanoma removed from her hand.
I had my first cancer cut out of the back of my hand about 2 months ago. I went to my local GP, a bloke I went to school with, and he took a look and said we’d better cut it out. It was sent off to the pathology lab and I went back about 10 days later to get the stitches out.
He looked at it and then hopped up and walked out of the office, as he was doing so he turned around and announced, “Yep, it’s cancer” and kept on walking. A minute later he came back in and looking slightly abashed said, “oops, sorry about that, yep it’s cancer, but it’s nothing to worry about. I get so used to announcing it I sometimes forget how it can effect some people”.
sibeen said:
I had my first cancer cut out of the back of my hand about 2 months ago. I went to my local GP, a bloke I went to school with, and he took a look and said we’d better cut it out. It was sent off to the pathology lab and I went back about 10 days later to get the stitches out.He looked at it and then hopped up and walked out of the office, as he was doing so he turned around and announced, “Yep, it’s cancer” and kept on walking. A minute later he came back in and looking slightly abashed said, “oops, sorry about that, yep it’s cancer, but it’s nothing to worry about. I get so used to announcing it I sometimes forget how it can effect some people”.
you’re not dying are you?? I’m not sure what I’d do… ;)
>you’re not dying are you?
Unfortunately, yes. I’m moving towards death at 1 second per second, just like everyone else :)
sibeen said:
>you’re not dying are you?Unfortunately, yes. I’m moving towards death at 1 second per second, just like everyone else :)
join the club ;)
diddly-squat said:
Michael V said:
I had a parotid tumour when I was about 21 or so. The (expensive) doctor looked at it carefully every six months for three years before he whipped it out. After the massive operation he said it was benign, but still wanted to see me 6-monthly for 5 years.
My missus had a benign melanoma removed about three and bit years ago… she had to get a check up every three months for the first two years and is now on 6 monthly check ups…
benign melanoma?
i’m often used by the local hospital as a visual aid for the students. i normally have to just stand there and say nothing, allowing the frigid air bring goosebumps to my supple skin whilst some geezer in a white coat talks to the audience shaking his head poking at my lumps with his lollipop stick.. on good days i can make as much as 20 dollars.
COME ON PEOPLE THROW ME A FRIGGIN BONE HERE!!
Dropbear said:
diddly-squat said:
Michael V said:
I had a parotid tumour when I was about 21 or so. The (expensive) doctor looked at it carefully every six months for three years before he whipped it out. After the massive operation he said it was benign, but still wanted to see me 6-monthly for 5 years.
My missus had a benign melanoma removed about three and bit years ago… she had to get a check up every three months for the first two years and is now on 6 monthly check ups…
benign melanoma?
sorry… that made no sense…
it was an early stage melanoma… but she has since had other benign moles removed…
sibeen said:
A minute later he came back in and looking slightly abashed said, “oops, sorry about that, yep it’s cancer, but it’s nothing to worry about. I get so used to announcing it I sometimes forget how it can effect some people”.
Dissolving into a blubbering heap and making a puddle in the corner can throw people off their game, somewhat.
I hope the balance of the 11 minute standard consultation time was sufficient for you to recover your dignity.
;-)
sibeen said:
>you’re not dying are you?Unfortunately, yes. I’m moving towards death at 1 second per second, just like everyone else :)
join the club ;)
Unfortunately, yes. I’m moving towards death at 1 second per second, just like everyone else :)
———————————
Unfortunately, yes. I’m moving towards death at 1 second per second, just like everyone else in the same inertial frame of reference. :)
fixed
buffy said:
Yes, perhaps I was too obtuse. I know we expect more info now than even 40 years ago. But even now, if a lesion turned out to be non malignant, would you be told, after the surgery had been done? Wouldn’t that invite litigation?
There is also some recent research showing that some breast lumps actually just disappear given time. But we are in a place medically that can’t afford to wait and see.
Watchful waiting is no longer practised a lot.
Usually, yes, there is a slight ‘push’ for medical types to apologise as apparently it doesn’t alter litigation claims (and has been found to reduce them).
poikilotherm said:
buffy said:Yes, perhaps I was too obtuse. I know we expect more info now than even 40 years ago. But even now, if a lesion turned out to be non malignant, would you be told, after the surgery had been done? Wouldn’t that invite litigation?
There is also some recent research showing that some breast lumps actually just disappear given time. But we are in a place medically that can’t afford to wait and see.
Watchful waiting is no longer practised a lot.
Usually, yes, there is a slight ‘push’ for medical types to apologise as apparently it doesn’t alter litigation claims (and has been found to reduce them).
An I’m no doktard, but our indemnity insurance people tell us to apologise immediately in the list of ‘things to do’ when something goes wrong.
poikilotherm said:
If only we could get everybody to do this, society would be so much richer (in all senses).
poikilotherm said:
buffy said:Yes, perhaps I was too obtuse. I know we expect more info now than even 40 years ago. But even now, if a lesion turned out to be non malignant, would you be told, after the surgery had been done? Wouldn’t that invite litigation?
There is also some recent research showing that some breast lumps actually just disappear given time. But we are in a place medically that can’t afford to wait and see.
Watchful waiting is no longer practised a lot.
Usually, yes, there is a slight ‘push’ for medical types to apologise as apparently it doesn’t alter litigation claims (and has been found to reduce them).
An I’m no doktard, but our indemnity insurance people tell us to apologise immediately in the list of ‘things to do’ when something goes wrong.